Prenatal Weight Gain Counseling and Excessive Gestational Weight Gain in Pre-Pregnant Normal Weight Women

Abstract

Objectives: Almost half of all pregnant women gain excessive weight during pregnancy, which is linked to a variety of poor pregnancy and long term outcomes including post-partum weight retention and obesity. Given the large number of women at risk for excessive gestational weight gain, prenatal visits offer a vital opportunity for obesity prevention. The objective of this study was to assess whether receipt of prenatal weight gain counseling is associated with a decreased risk of excessive weight gain among pre-pregnant normal weight women. Methods: We conducted a population-based case control study of normal weight women using the Washington State Pregnancy Risk Assessment Monitoring System (PRAMS) data to examine the association of self-reported receipt of pregnancy weight gain counseling during prenatal care and excessive gestational weight gain. Women were eligible for participation if they had a normal body mass index (BMI) of 18.5 -24.9 kg/m2, delivered a live-born singleton infant, and were interviewed as part of PRAMS from 2004-2008. Cases were women who gained excessive, and controls were those who gained adequate gestational weight according to 1990 Institute of Medicine Guidelines. Because excess weight gain was not rare, we used Poisson regression using generalized linear models with a log-link function to estimate the relative risk (RR) and 95% confidence interval (CI) for the association between prenatal weight counseling and excessive weight gain. Results: Of the 2,157 women eligible for the study, 49.6% gained excessive weight and 83.9% reported that their provider discussed weight gain during pregnancy. Weight counseling was not associated with excess weight gain. (RR 1.03, 95% CI: 0.88-1.20). Conclusions: Prenatal counseling was not associated with a decreased risk of excessive gestational weight gain. Perhaps counseling alone is not sufficient to prevent excess gestational weight gain. Further research should not only seek to identify effective counseling methods and resources, but also modifiable maternal and community factors that contribute to healthy weight gain during pregnancy.