Fieldwick Diana, Smith Alesha, Paterson Helen
Tauranga Hospital, Tauranga, New Zealand.
School of Pharmacy, University of Otago, Dunedin, New Zealand.
Aust N Z J Obstet Gynaecol. 2017 Aug;57(4):420-425. doi: 10.1111/ajo.12609. Epub 2017 Mar 17.
Childhood obesity is a growing concern internationally and a top priority for the World Health Organization. Preconception overweight, obesity and excess gestational weight gain significantly increase childhood obesity risk. Optimising preconception weight is a key preventative measure toward reducing childhood obesity. In 2014, the New Zealand (NZ) Ministry of Health released guidance for health practitioners on healthy weight gain in pregnancy in an effort to reduce the burden of childhood obesity.
To explore the knowledge and practice of NZ general practitioners (GPs) regarding preconception and gestational weight management.
A nationwide survey was conducted on a randomly selected sample of NZ GPs using a mixed methods approach. Descriptive statistics were used for survey responses and a general inductive approach was applied to the free text data.
A total of 200 GPs (42.5%) responded. The majority of GPs were aware of the risks of obesity in pregnancy. Over 50% of GPs reported practice that was not consistent with recommended standards of care. Ministry of Health guidance was known to only 12% of participants. Themes emerging from the free text data included: lack of opportunity for, and awareness of, preconception care; recognition of the importance of this area; and need for further learning.
General practitioners in NZ are not providing optimal preconception care. This research highlights the need for a public health message encouraging preconception counselling and better education of GPs on the topic. This should start with promotion of the Ministry of Health guidance.
儿童肥胖问题在国际上日益受到关注，是世界卫生组织的首要任务。孕前超重、肥胖和孕期体重过度增加会显著增加儿童肥胖风险。优化孕前体重是降低儿童肥胖的关键预防措施。2014年，新西兰卫生部发布了针对健康从业者的孕期健康体重增加指南，以减轻儿童肥胖的负担。
探讨新西兰全科医生（GP）在孕前和孕期体重管理方面的知识和实践。
采用混合方法对随机抽取的新西兰全科医生样本进行全国性调查。对调查回复使用描述性统计，并对自由文本数据采用一般归纳法。
共有200名全科医生（42.5%）回复。大多数全科医生意识到孕期肥胖的风险。超过50%的全科医生报告其做法不符合推荐的护理标准。只有12%的参与者知晓卫生部的指南。自由文本数据中出现的主题包括：缺乏孕前护理的机会和意识；认识到该领域的重要性；以及需要进一步学习。
新西兰的全科医生没有提供最佳的孕前护理。这项研究强调需要发出公共卫生信息，鼓励孕前咨询，并对全科医生进行关于该主题的更好教育。这应从推广卫生部的指南开始。
