The Healthy Pregnancy Service to Optimise Excess Gestational Weight Gain for Women with Obesity: A Qualitative Study of Health Professionals’ Perspectives

Maternal obesity is associated with health risks for women and their babies, exacerbated by excess gestational weight gain. We describe health professionals’ perspectives in the provision of a Healthy Pregnancy service designed to optimise healthy lifestyle and support recommended gestational weight gain for women with obesity. Semi-structured interviews were conducted with health professionals. Questions were based on the Theoretical Domains Framework (TDF) and deductive thematic analysis was performed. A total of 14 multidisciplinary staff were interviewed. Six themes were identified: 1. health professionals view themselves as part of a team; 2. health professionals reported having necessary skills; 3. experience generated confidence in discussing gestational weight gain; 4. gestational weight gain is considered of variable importance; 5. health professionals want women to be comfortable; 6. the environmental context and resources presented some barriers. Staff were supportive of the Healthy Pregnancy service and valued developing teamwork with staff and rapport with women. Most felt relatively comfortable discussing weight gain with women. Barriers included ability to navigate sensitive topics with women, limited awareness of the intervention among new staff, communication between teams, and waiting time for women. Barriers and enablers to the delivery of an integrated model of maternity care were identified. These findings should inform and improve implementation of service models integrating healthy lifestyle in the antenatal care of women with obesity.

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Facilitators and barriers to behaviour change within a lifestyle program for women with obesity to prevent excess gestational weight gain: a mixed methods evaluation

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04034-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rebecca F. Goldstein ◽

Jacqueline A. Boyle ◽

Clement Lo ◽

Helena J. Teede ◽

Cheryce L. Harrison

Keyword(s):

Mixed Methods ◽

Weight Gain ◽

Gestational Weight Gain ◽

Behaviour Change ◽

Healthy Lifestyle ◽

Scale Up ◽

Motivation To Change ◽

Gestational Weight ◽

Barriers And Enablers ◽

Healthy Pregnancy

Abstract Background Maternal obesity is associated with health risks for women and their babies and is exacerbated by excess gestational weight gain. The aim of this study was to describe women’s experiences and perspectives in attending a Healthy Pregnancy Service designed to optimise healthy lifestyle and support recommended gestational weight gain for women with obesity. Methods An explanatory sequential mixed methods study design utilised two questionnaires (completed in early and late pregnancy) to quantify feelings, motivation and satisfaction with the service, followed by semi-structured interviews that explored barriers and enablers of behaviour change. Data were analysed separately and then interpreted together. Results Overall, 49 women attending the service completed either questionnaire 1, 2 or both and were included in the analysis. Fourteen women were interviewed. Prior to pregnancy, many women had gained weight and attempted to lose weight independently, and reported they were highly motivated to achieve a healthy lifestyle. During pregnancy, diet changes were reported as easier to make and sustain than exercise changes. Satisfaction with the service was high. Key factors identified in qualitative analysis were: service support enabled change; motivation to change behaviour, social support, barriers to making change (intrinsic, extrinsic and clinic-related), post-partum lifestyle and needs. On integration of data, qualitative and quantitative findings aligned. Conclusions The Healthy Pregnancy service was valued by women. Barriers and enablers to the delivery of an integrated model of maternity care that supported healthy lifestyle and recommended gestational weight gain were identified. These findings have informed and improved implementation and further scale up of this successful service model, integrating healthy lifestyle into routine antenatal care of women with obesity. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry (no.12620000985987). Registration date 30/09/2020, retrospectively registered. http://www.anzctr.org.au/

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Paternal and maternal obesity but not gestational weight gain is associated with type 1 diabetes

International Journal of Epidemiology ◽

10.1093/ije/dyx266 ◽

2018 ◽

Vol 47 (2) ◽

pp. 417-426 ◽

Cited By ~ 10

Author(s):

Maria C Magnus ◽

Sjurdur F Olsen ◽

Charlotta Granstrom ◽

Nicolai A Lund-Blix ◽

Jannet Svensson ◽

...

Keyword(s):

Type 1 Diabetes ◽

Weight Gain ◽

Gestational Weight Gain ◽

Maternal Obesity ◽

Gestational Weight

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Gestational Weight Gain and Changes in Body Composition in Pregnant Women with BMI ≥25 Kg/m2 Undergoing a Healthy Lifestyle Program Starting Early in Pregnancy

Journal of Obesity & Weight loss Therapy ◽

10.4172/2165-7904.1000300 ◽

2016 ◽

Vol 06 (01) ◽

Author(s):

Marcella Malavolti ◽

Elisabetta Petrella

Keyword(s):

Body Composition ◽

Weight Gain ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Healthy Lifestyle ◽

Gestational Weight ◽

Lifestyle Program ◽

Healthy Lifestyle Program ◽

In Pregnancy

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Impact of maternal obesity on pregnancy course and maternal and perinatal complications

Medicinski podmladak ◽

10.5937/mp71-27850 ◽

2020 ◽

Vol 71 (3) ◽

pp. 54-58

Author(s):

Milan Lacković

Keyword(s):

Risk Factors ◽

Weight Gain ◽

Gestational Weight Gain ◽

Pregnancy Complications ◽

Maternal Obesity ◽

Overweight And Obesity ◽

Perinatal Complications ◽

Anthropometric Parameter ◽

Gestational Weight ◽

Excessive Gestational Weight Gain

The prevalence of obesity and obesity-related health problems is increasing worldwide, especially among woman and man of reproductive age and obesity is designated as one of the most important global health threats in 21st century. Pregnancy in obese woman is considered as a high-risk pregnancy. Pre-pregnancy obesity and excessive gestational weight gain (GWG) are distinct risk factors with differing associated adverse outcomes, but they could also carry a cumulative negative impact on pregnancy course. Pre-pregnancy obesity is the anthropometric parameter most strongly correlated with perinatal complications. Maternal complications following obesity include antepartum, intrapartum and postpartum complications, such as pregnancy related hypertension, preeclampsia, gestational diabetes mellitus, preterm birth, venous thromboembolism, labor dystocia, labor induction, instrumental and cesarean delivery. Fetal complications related to maternal obesity might include increased prevalence of congenital anomalies, growth abnormalities, prematurity and stillbirth. Pre- pregnancy overweight and obesity is a potentially modifiable risk factor compromising pregnancy outcome. Among all complications that might arise during pregnancy and that could not be predicted and therefore prevented, pre- pregnancy overweight and obesity management control can significantly reduce potential pregnancy complications. Pre-conceptual counseling should provide in a timely manner awareness of this arising medical condition and provide risk reduction of complications following pre- pregnancy obesity and excessive GWG obesity, pre-pregnancy obesity, excessive gestational weight gain, pregnancy risk factors, pregnancy complications

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