Vinturache Angela E, Winn Anika, Tough Suzanne C
Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
Faculty of Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Matern Child Health J. 2017 Nov;21(11):2092-2101. doi: 10.1007/s10995-017-2324-x.
Objective The objective of this study was to evaluate the recall of prenatal counselling received among overweight and obese women in primary care settings. Methods A sample of 1996 women with singleton, term deliveries and pre-pregnancy BMI >18.5 kg/m were identified from the All Our Babies pregnancy cohort. Information on socio-demographic characteristics and women's experiences with prenatal counselling on nutrition, vitamin and mineral supplements, exercise, weight gain, employment, alcohol and drug use, and smoking during pregnancy were collected through questionnaires administered at <25 weeks and 34-36 weeks gestation. Multivariable logistic regression analyses explored the associations between pre-pregnancy BMI and the domains of prenatal counselling, controlling for confounders. Results Women reported high levels of comfort asking questions and satisfaction with their health care provider. Women reported getting information about nutrition (69.3%), weight gain (67.8%), exercise (64.4%), vitamins and minerals supplementation (86.1%). Obese women (211, 10.6%) were more likely than normal weight women (1313, 65.8%) to be Caucasian (p = 0.004), less educated (p = 0.001), and to have been born or lived in Canada for at least 5 years (p = 0.01). There was no difference in the prenatal advice received on nutrition, weight gain and exercise in pregnancy between obese, overweight, and normal weight women. Conclusions for Practice Pre-pregnancy BMI did not appear to influence the recall of prenatal counselling women receive in community health care centers. Given the importance of nutrition and weight gain during pregnancy, and guidelines for weight gain based on pre-pregnancy BMI, there are missed opportunities in knowledge exchange between women and providers in the prenatal period.
目的 本研究的目的是评估初级保健机构中超重和肥胖女性对产前咨询的记忆情况。方法 从“我们所有的宝宝”妊娠队列中确定了1996名单胎足月分娩且孕前体重指数(BMI)>18.5kg/m²的女性样本。通过在妊娠<25周和34 - 36周时发放的问卷,收集社会人口学特征信息以及女性在营养、维生素和矿物质补充剂、运动、体重增加、就业、孕期饮酒和吸毒以及吸烟等方面的产前咨询经历。多变量逻辑回归分析探讨了孕前BMI与产前咨询各领域之间的关联,并对混杂因素进行了控制。结果 女性报告称在向医疗服务提供者提问时感到高度舒适且对其满意度较高。女性报告获取了关于营养(69.3%)、体重增加(67.8%)、运动(64.4%)、维生素和矿物质补充(86.1%)的信息。肥胖女性(211名,10.6%)比正常体重女性(1313名,65.8%)更有可能是白种人(p = 0.004)、受教育程度较低(p = 0.001),并且在加拿大出生或居住至少5年(p = 0.01)。肥胖、超重和正常体重女性在孕期接受的关于营养、体重增加和运动的产前建议没有差异。实践结论 孕前BMI似乎并未影响女性在社区医疗中心接受的产前咨询的记忆情况。鉴于孕期营养和体重增加的重要性以及基于孕前BMI的体重增加指南,在产前阶段女性与医疗服务提供者之间的知识交流存在错失的机会。