Johnson Maxine, Campbell Fiona, Messina Josie, Preston Louise, Buckley Woods Helen, Goyder Elizabeth
School of Health and Related Research (ScHARR), University of Sheffield, United Kingdom.
Midwifery. 2013 Dec;29(12):1287-96. doi: 10.1016/j.midw.2012.11.016. Epub 2013 Feb 22.
increasing overweight and obesity rates in pregnant women present health risks to mother and unborn infant.
to identify barriers and facilitators to implementing and carrying out maternal weight management interventions.
searches were carried out in medical, midwifery and nursing databases, augmented by hand searching of midwifery journals.
articles were included that were published in the UK after 1990, with a focus on women's and health professional's views about weight management during pregnancy.
from 6423 citations, 126 full text papers were retrieved. Of these, 18 (reporting 17 studies) fulfilled the inclusion criteria. Included papers were assessed for quality. Reported findings were analysed and synthesised using thematic analysis.
a major theme was access to relevant and appropriate information; advice was reported as vague or inadequate. Overweight or obese women reported feelings of stigmatisation during routine examinations. Health professionals reported a reluctance to discuss weight with larger women. Perceived risk to the fetus as well as changes in women's physiological responses to pregnancy, were reported barriers to optimal physical activity and dietary intake. Perceptions of control were related to women's feelings about their body image.
evidence suggests that the complexity of interactions with advice sources, bodily changes, feelings of control, as well as perceived risks may explain the relative ineffectiveness of weight management interventions during pregnancy. Focusing on healthy diet and physical activity levels may be more useful and less stigmatising than focusing on weight.
孕妇超重和肥胖率不断上升，给母亲和未出生婴儿带来健康风险。
确定实施和开展孕产妇体重管理干预措施的障碍和促进因素。
在医学、助产和护理数据库中进行检索，并通过手工检索助产期刊进行补充。
纳入1990年后在英国发表的文章，重点关注女性和健康专业人员对孕期体重管理的看法。
从6423条引用文献中检索出126篇全文论文。其中，18篇（报告了17项研究）符合纳入标准。对纳入的论文进行质量评估。使用主题分析法对报告的研究结果进行分析和综合。
一个主要主题是获取相关且合适的信息；报告称建议含糊不清或不充分。超重或肥胖女性在常规检查中表示有受歧视感。健康专业人员报告称不愿与体型较大的女性讨论体重问题。对胎儿的感知风险以及女性孕期生理反应的变化，被报告为最佳身体活动和饮食摄入的障碍。对控制的认知与女性对自身身体形象的感受有关。
证据表明，与建议来源的互动复杂性、身体变化、控制感以及感知风险，可能解释了孕期体重管理干预措施相对无效的原因。关注健康饮食和身体活动水平可能比关注体重更有用，且更少带来歧视。
