Bradford Heather M, Puhl Rebecca M, Phillippi Julia C, Dietrich Mary S, Neal Jeremy L
Georgetown University School of Nursing, Washington, District of Columbia, USA.
University of Connecticut, Storrs, Connecticut, USA.
Birth. 2025 Jun;52(2):189-206. doi: 10.1111/birt.12870. Epub 2024 Sep 19.
Weight bias toward individuals with higher body weights in healthcare settings is associated with adverse health behaviors, reduced healthcare utilization, and poor health outcomes. The purpose of this integrative review was to explore: (1) What has been measured and described regarding perinatal care providers' and students' weight bias toward pregnant, birthing, and postpartum individuals with higher body weights? (2) What has been measured and described regarding pregnant, birthing, and postpartum individuals' experiences of weight bias? (3) What is the association of experiences of weight bias with perinatal and mental health outcomes among pregnant, birthing, and postpartum individuals?
We conducted a systematic search in CINAHL, PubMed, and PsycINFO databases to identify relevant research publications related to the Medical Subject Headings (MeSH) terms weight prejudice (and related terms) and pregnancy (and related terms). The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Johns Hopkins Nursing Evidence-Based Practice model for study quality determination, and the Whittemore and Knafl integrative review framework for data extraction and analyses.
Twenty-two publications met inclusion criteria, representing six countries and varying study designs. This review found pervasive sources of explicit weight bias in the perinatal period, including care providers and close relationships. Experiences of weight bias among pregnant and postpartum individuals are associated with adverse perinatal and mental health outcomes.
The findings address a knowledge gap regarding a summary of literature on weight bias in the perinatal period and elucidate its prevalence as well as its negative influence on perinatal and mental health outcomes. Future research efforts on this topic must examine the nature and extent of perinatal care providers' weight bias by demographic factors and explore its association with clinical decision-making and perinatal and mental health outcomes.
在医疗环境中，对体重较高个体的体重偏见与不良健康行为、医疗保健利用率降低以及健康状况不佳有关。本整合性综述的目的是探讨：（1）关于围产期护理提供者和学生对体重较高的孕妇、产妇和产后女性的体重偏见，有哪些已被测量和描述的内容？（2）关于孕妇、产妇和产后女性的体重偏见经历，有哪些已被测量和描述的内容？（3）体重偏见经历与孕妇、产妇和产后女性的围产期和心理健康结果之间有什么关联？
我们在CINAHL、PubMed和PsycINFO数据库中进行了系统检索，以识别与医学主题词（MeSH）术语“体重偏见”（及相关术语）和“妊娠”（及相关术语）相关的研究出版物。该综述以系统评价和Meta分析的首选报告项目（PRISMA）、用于研究质量判定的约翰霍普金斯循证护理实践模型以及用于数据提取和分析的惠特莫尔和克纳夫整合性综述框架为指导。
22篇出版物符合纳入标准，代表六个国家且研究设计各异。本综述发现围产期存在普遍的显性体重偏见来源，包括护理提供者和亲密关系。孕妇和产后女性的体重偏见经历与不良围产期和心理健康结果相关。
这些发现填补了围产期体重偏见文献综述方面的知识空白，阐明了其普遍性及其对围产期和心理健康结果的负面影响。未来关于该主题的研究工作必须按人口统计学因素研究围产期护理提供者体重偏见的性质和程度，并探讨其与临床决策以及围产期和心理健康结果的关联。
