Department of Food and Resource Economics, University of Copenhagen, Frederiksberg, Denmark.
Department of Food and Resource Economics, Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark.
Health Expect. 2018 Oct;21(5):878-886. doi: 10.1111/hex.12681. Epub 2018 Apr 6.
Pregnant women with a body mass index (BMI) ≥ 30 kg/m have been targeted in health-care systems in many western countries as a high-risk group. However, we have limited knowledge of the long-term significance of this prenatal care policy.
To investigate accounts women give of their experiences of being targeted as severely overweight during pregnancy when they look back at the intervention 4-5 years later.
Interpretive analysis based on 21 semi-structured interviews conducted 4-5 years after the pregnancy with Danish mothers categorized as having a pre-pregnancy BMI ≥ 30.
In the women's retrospective accounts three phases were identified and separated: (i) Being identified as a "severely overweight pregnant woman." The women differed over whether they accepted this categorization, but all believed that an approach based on weight was acceptable. (ii) Encounters with health-care professionals. The women differed here: some reported no negative experiences; others reported experiences of prejudice and silence. (iii) Reflections on long-term outcomes. Most women reported that the interventions during their pregnancies did not lead to any lasting lifestyle change. The women disagreed over whether, in principle, pregnancy was a suitable time to be targeted.
Our study illustrates the importance of critically considering whether pregnancy is a suitable window of opportunity for obesity prevention, and shows that women's experiences should be examined in relation to each phase of intervention. More interdisciplinary studies are needed to map potential benefits and other consequences over the short- and long-term.
在许多西方国家的医疗保健系统中，将身体质量指数（BMI）≥30kg/m²的孕妇确定为高危人群。然而，我们对这种产前保健政策的长期意义知之甚少。
调查女性在回顾性研究中对怀孕时被视为严重超重的经历的描述，该研究在怀孕后 4-5 年进行。
基于 21 名丹麦母亲的半结构式访谈进行解释性分析，这些母亲在怀孕前的 BMI≥30。
在女性的回顾性叙述中，确定并分离出三个阶段：（i）被确定为“严重超重孕妇”。女性对是否接受这种分类存在分歧，但都认为基于体重的方法是可以接受的。（ii）与医疗保健专业人员的接触。这里女性之间存在差异：一些人报告没有负面经历；其他人则报告了偏见和沉默的经历。（iii）对长期结果的反思。大多数女性报告说，怀孕期间的干预措施并没有导致任何持久的生活方式改变。女性不同意怀孕期间是否是预防肥胖的合适时机。
我们的研究说明了批判性地考虑怀孕是否是预防肥胖的合适时机的重要性，并表明应根据干预的每个阶段来检查女性的经历。需要更多的跨学科研究来绘制短期和长期的潜在益处和其他后果。
