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超重和肥胖孕妇体重管理的医疗保健相关障碍与促进因素:一项快速综述

Healthcare related barriers and enablers for weight management among pregnant women with overweight and obesity: a rapid scoping review.

作者信息

Vasilevski Vidanka, Mekonnen Alemayehu, Peeters Anna, Chapman Anna, Naughton Shaan, Yuen Eva, Ananthapavan Jaithri, Holmes-Truscott Elizabeth, Willcox Jane, Graham Kristen, Sweet Linda

机构信息

School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, 221 Burwood Hwy, Burwood, 3125, VIC, Australia.

Western Health, Melbourne, Australia.

出版信息

BMC Pregnancy Childbirth. 2025 Mar 7;25(1):252. doi: 10.1186/s12884-025-07262-3.

Abstract

BACKGROUND

Overweight and obesity in pregnancy are associated with health risks for women and babies. Providing effective weight management during pregnancy is necessary to support appropriate gestational weight gain and improve outcomes for women and their infants. This study aimed to synthesise evidence documenting healthcare-related barriers and enablers for weight management among pregnant women with overweight or obesity in English-speaking high-income countries.

METHODS

An initial rapid scoping review focusing on the healthcare-related barriers and enablers for weight management in all populations with overweight or obesity was undertaken. Due to the unique weight management needs of pregnant women, this study analysed a sub-set of publications collected in the initial review pertaining to pregnant women. All publication types (except protocols and conference abstracts) were eligible for inclusion. The search was limited to publications from 2010 onwards. Academic and grey literature were identified, screened, and data extracted. Findings were summarised thematically.

RESULTS

The initial review search, including all populations, identified 12,762 unique abstracts, and 181 full-text articles. Of these, 22 focused on pregnant women living with overweight or obesity. A further four articles were identified via citation searches of the included articles. The identified barriers and enablers for pregnancy weight management in healthcare settings fell under three broad themes: (1) access to, and engagement with, weight management advice during pregnancy (2), challenges for providing weight management support in healthcare settings, and (3) healthcare provider confidence in providing weight management advice during pregnancy.

CONCLUSION

Pregnant women with overweight or obesity are not receiving adequate weight management guidance. Multi-level strategies are needed to ensure pregnant women have access to weight management care that is stigma-free, easily accessible, tailored to their individual needs and fosters positive relationships with healthcare providers.

摘要

背景

孕期超重和肥胖会给女性和婴儿带来健康风险。在孕期提供有效的体重管理对于支持适当的孕期体重增加以及改善女性及其婴儿的结局至关重要。本研究旨在综合证据,记录英语国家高收入地区超重或肥胖孕妇在体重管理方面与医疗保健相关的障碍和促进因素。

方法

首先进行了一项快速范围综述,重点关注所有超重或肥胖人群在体重管理方面与医疗保健相关的障碍和促进因素。由于孕妇有独特的体重管理需求,本研究分析了在初步综述中收集的与孕妇相关的一部分出版物。所有出版物类型(协议和会议摘要除外)均符合纳入标准。搜索限于2010年以后发表的文献。对学术文献和灰色文献进行了识别、筛选和数据提取。研究结果按主题进行了总结。

结果

初步综述搜索(包括所有人群)共识别出12,762篇独特摘要和181篇全文文章。其中,22篇关注超重或肥胖的孕妇。通过对纳入文章的引用搜索又识别出另外4篇文章。在医疗保健环境中,已识别出的孕期体重管理障碍和促进因素可归为三大主题:(1)孕期体重管理建议的获取和参与;(2)在医疗保健环境中提供体重管理支持的挑战;(3)医疗保健提供者在孕期提供体重管理建议的信心。

结论

超重或肥胖的孕妇未得到充分的体重管理指导。需要采取多层次策略,以确保孕妇能够获得无歧视、易于获得、符合其个人需求并能促进与医疗保健提供者建立积极关系的体重管理护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9e4/11889784/721f433ce9fb/12884_2025_7262_Fig1_HTML.jpg

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