Department of Research, American College of Obstetricians and Gynecologists , Washington, District of Colombia.
J Womens Health (Larchmt). 2017 Nov;26(11):1169-1175. doi: 10.1089/jwh.2016.6236. Epub 2017 Jun 12.
Assess obstetrician-gynecologists' knowledge and counseling practices regarding gestational weight gain (GWG).
Questionnaire studies were conducted in 2012 and 2014 sent to practicing obstetrician-gynecologists.
Response rates were 111/236 (47%) and 206/474 (43.5%). The majority of respondents agreed (50.0%) or strongly agreed (26.6%) that excessive GWG is a major health concern, often or always calculate the body mass index (BMI) of their patients (79.1%), and use BMI to modify their weight gain recommendations (78.5%). The physicians reported that, on average, 7.8% of pregnant patients gained too little weight, 47.3% gained an appropriate amount, and 45.1% gained too much. A greater proportion of patients with private insurance was associated with physician perception of fewer gaining excessive weight (r = -0.205, n = 198, p = 0.004), whereas high proportions with Medicaid or uninsured were positively correlated with a perception of excessive GWG (r = 0.206 and 0.187, n = 198, p = 0.004 and 0.008, respectively). A majority of physicians (55.1%) were not confident in their ability to affect their patients' prenatal weight gain. Confident physicians exhibited more appropriate practice efforts (e.g., use prepregnancy BMI; 83.6% vs. 74.8%, p = 0.009) and were more likely to inform their patients about the increased risk of pregnancy complications (90.8% vs. 69.7%, p = 0.001) and possible harms to their baby (76.9% vs. 61.0%, p = 0.001) from excessive GWG.
Study participants perceived excessive GWG to be a significant problem, but had low confidence in their ability to address it.
评估妇产科医生在妊娠体重增加(GWG)方面的知识和咨询实践。
2012 年和 2014 年向妇产科医生进行了问卷调查研究。
回应率分别为 111/236(47%)和 206/474(43.5%)。大多数受访者(50.0%)或强烈同意(26.6%)认为过多的 GWG 是一个主要的健康问题,经常或总是计算患者的体重指数(BMI)(79.1%),并使用 BMI 来修改他们的体重增加建议(78.5%)。医生报告说,平均而言,7.8%的孕妇体重增加不足,47.3%的孕妇体重增加适量,45.1%的孕妇体重增加过多。有私人保险的患者比例较高与医生认为体重增加过多的比例较低相关(r=-0.205,n=198,p=0.004),而 Medicaid 或无保险患者比例较高与认为 GWG 过多相关(r=0.206 和 0.187,n=198,p=0.004 和 0.008)。大多数医生(55.1%)对影响患者产前体重增加的能力缺乏信心。有信心的医生表现出更适当的实践努力(例如,使用孕前 BMI;83.6%比 74.8%,p=0.009),更有可能告知患者 GWG 过多的妊娠并发症风险增加(90.8%比 69.7%,p=0.001)和对婴儿可能造成的伤害(76.9%比 61.0%,p=0.001)。
研究参与者认为过多的 GWG 是一个重大问题,但对自己解决这一问题的能力缺乏信心。