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Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

A qualitative study of gestational weight gain goal setting

Authors: Shaniece Criss, Emily Oken, Lauren Guthrie, Marie-France Hivert

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

Gestational weight gain (GWG) is an important predictor of short and long-term pregnancy outcomes for both mother and child, and women who set a GWG goal are more likely to gain within recommended ranges. Little information is available regarding potentially modifiable factors that underlie a woman’s GWG goals. Our aims were to explore women’s perceptions regarding factors that affect GWG, their understanding of appropriate GWG, their goal-setting experiences including patient-health care provider (HCP) conversations, and supportive interventions they would most like to help them achieve the recommended GWG.

Methods

We conducted nine in-depth interviews and seven focus groups with a total of 33 Boston, Massachusetts (MA) area women who were pregnant and had delivered within the prior 6 months. We recorded and transcribed all interviews. Two investigators independently coded resulting transcripts. We managed data using MAXQDA2 and conducted a content analysis.

Results

Perceived factors that contributed to GWG goal-setting included the mother’s weight control behaviors concerning exercise and diet—including a “new way of eating for two” and “semblance of control”, experiences during prior pregnancies, conversations with HCPs, and influence from various information sources. Women focused on behaviors with consistent messaging across multiple sources of information, but mainly trusted their HCP, valued one-to-one conversations with them about GWG, preferred that the HCP initiate the conversation about GWG goals, and would be open to have the conversation started based on visual aid based on their own GWG progression.

Conclusions

Pregnant women highly value discussions with their HCP to set GWG goals. Pregnant women view their clinicians as the most reliable source of information and believe that clinicians should open weight-related discussions throughout pregnancy.
Literature
1.
go back to reference Nehring I, Schmoll S, Beyerlein A, Hauner H, Von Kries R. Gestational weight gain and long-term postpartum weight retention: a meta-analysis. Am J Clin Nutr. 2011;94:1225–31.CrossRefPubMed Nehring I, Schmoll S, Beyerlein A, Hauner H, Von Kries R. Gestational weight gain and long-term postpartum weight retention: a meta-analysis. Am J Clin Nutr. 2011;94:1225–31.CrossRefPubMed
2.
go back to reference Oken E, Kleinman KP, Belfort MB, Hammitt JK, Gillman MW. Associations of gestational weight gain with short-and longer-term maternal and child health outcomes. Am J Epidemiol. 2009;170:173–80.CrossRefPubMedPubMedCentral Oken E, Kleinman KP, Belfort MB, Hammitt JK, Gillman MW. Associations of gestational weight gain with short-and longer-term maternal and child health outcomes. Am J Epidemiol. 2009;170:173–80.CrossRefPubMedPubMedCentral
3.
go back to reference Walter JR, Perng W, Kleinman KP, Rifas-Shiman SL, Rich-Edwards JW, Oken E. Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum. Am J Obstet Gynecol. 2015;212:499. e1–499. e12.CrossRef Walter JR, Perng W, Kleinman KP, Rifas-Shiman SL, Rich-Edwards JW, Oken E. Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum. Am J Obstet Gynecol. 2015;212:499. e1–499. e12.CrossRef
5.
go back to reference Fraser A, Tilling K, Macdonald-Wallis C, Hughes R, Sattar N, Nelson SM, Lawlor DA. Associations of gestational weight gain with maternal body mass index, waist circumference, and blood pressure measured 16 y after pregnancy: the Avon Longitudinal Study of Parents and Children (ALSPAC). Am J Clin Nutr. 2011;93:1285–92.CrossRefPubMedPubMedCentral Fraser A, Tilling K, Macdonald-Wallis C, Hughes R, Sattar N, Nelson SM, Lawlor DA. Associations of gestational weight gain with maternal body mass index, waist circumference, and blood pressure measured 16 y after pregnancy: the Avon Longitudinal Study of Parents and Children (ALSPAC). Am J Clin Nutr. 2011;93:1285–92.CrossRefPubMedPubMedCentral
6.
go back to reference Fraser A, Tilling K, Macdonald-Wallis C, Sattar N, Brion M-J, Benfield L, Ness A, Deanfield J, Hingorani A, Nelson SM. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010;121:2557–64.CrossRefPubMedPubMedCentral Fraser A, Tilling K, Macdonald-Wallis C, Sattar N, Brion M-J, Benfield L, Ness A, Deanfield J, Hingorani A, Nelson SM. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010;121:2557–64.CrossRefPubMedPubMedCentral
7.
go back to reference Hivert MF, Rifas‐Shiman SL, Gillman MW, Oken E. Greater early and mid‐pregnancy gestational weight gains are associated with excess adiposity in mid‐childhood. Obesity. 2016;24(7):1546–53.CrossRefPubMed Hivert MF, Rifas‐Shiman SL, Gillman MW, Oken E. Greater early and mid‐pregnancy gestational weight gains are associated with excess adiposity in mid‐childhood. Obesity. 2016;24(7):1546–53.CrossRefPubMed
8.
go back to reference Hochner H, Friedlander Y, Calderon-Margalit R, Meiner V, Sagy Y, Avgil-Tsadok M, Burger A, Savitsky B, Siscovick DS, Manor O. Associations of maternal prepregnancy body mass index and gestational weight gain with adult offspring cardiometabolic risk factors the Jerusalem Perinatal Family Follow-up Study. Circulation. 2012;125:1381–9.CrossRefPubMedPubMedCentral Hochner H, Friedlander Y, Calderon-Margalit R, Meiner V, Sagy Y, Avgil-Tsadok M, Burger A, Savitsky B, Siscovick DS, Manor O. Associations of maternal prepregnancy body mass index and gestational weight gain with adult offspring cardiometabolic risk factors the Jerusalem Perinatal Family Follow-up Study. Circulation. 2012;125:1381–9.CrossRefPubMedPubMedCentral
9.
go back to reference Karachaliou M, Georgiou V, Roumeliotaki T, Chalkiadaki G, Daraki V, Koinaki S, Dermitzaki E, Sarri K, Vassilaki M, Kogevinas M. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am J Obstet Gynecol. 2015;212:502. e1–502. e14.CrossRef Karachaliou M, Georgiou V, Roumeliotaki T, Chalkiadaki G, Daraki V, Koinaki S, Dermitzaki E, Sarri K, Vassilaki M, Kogevinas M. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am J Obstet Gynecol. 2015;212:502. e1–502. e14.CrossRef
10.
go back to reference Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW. Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol. 2008;112:999.CrossRefPubMedPubMedCentral Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW. Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol. 2008;112:999.CrossRefPubMedPubMedCentral
11.
go back to reference Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007;196:322. e1–8.CrossRef Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007;196:322. e1–8.CrossRef
12.
go back to reference Parker M, Rifas-Shiman SL, Oken E, Belfort MB, Jaddoe VW, Gillman MW. Second trimester estimated fetal weight and fetal weight gain predict childhood obesity. J Pediatr. 2012;161:864–870. e1.CrossRefPubMedPubMedCentral Parker M, Rifas-Shiman SL, Oken E, Belfort MB, Jaddoe VW, Gillman MW. Second trimester estimated fetal weight and fetal weight gain predict childhood obesity. J Pediatr. 2012;161:864–870. e1.CrossRefPubMedPubMedCentral
13.
go back to reference Durie DE, Thornburg LL, Glantz JC. Effect of second-trimester and third-trimester rate of gestational weight gain on maternal and neonatal outcomes. Obstet Gynecol. 2011;118:569–75.CrossRefPubMed Durie DE, Thornburg LL, Glantz JC. Effect of second-trimester and third-trimester rate of gestational weight gain on maternal and neonatal outcomes. Obstet Gynecol. 2011;118:569–75.CrossRefPubMed
14.
15.
go back to reference Park S, Sappenfield WM, Bish C, Salihu H, Goodman D, Bensyl DM. Assessment of the Institute of Medicine recommendations for weight gain during pregnancy: Florida, 2004–2007. Matern Child Health J. 2011;15:289–301.CrossRefPubMed Park S, Sappenfield WM, Bish C, Salihu H, Goodman D, Bensyl DM. Assessment of the Institute of Medicine recommendations for weight gain during pregnancy: Florida, 2004–2007. Matern Child Health J. 2011;15:289–301.CrossRefPubMed
16.
go back to reference Cogswell ME, Scanlon KS, Fein SB, Schieve LA. Medically advised, mother’s personal target, and actual weight gain during pregnancy. Obstet Gynecol. 1999;94:616–22.PubMed Cogswell ME, Scanlon KS, Fein SB, Schieve LA. Medically advised, mother’s personal target, and actual weight gain during pregnancy. Obstet Gynecol. 1999;94:616–22.PubMed
17.
go back to reference Tovar A, Guthrie LB, Platek D, Stuebe A, Herring SJ, Oken E. Modifiable predictors associated with having a gestational weight gain goal. Matern Child Health J. 2011;15:1119–26.CrossRefPubMedPubMedCentral Tovar A, Guthrie LB, Platek D, Stuebe A, Herring SJ, Oken E. Modifiable predictors associated with having a gestational weight gain goal. Matern Child Health J. 2011;15:1119–26.CrossRefPubMedPubMedCentral
18.
go back to reference Mcleroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Behav. 1988;15:351–77.CrossRef Mcleroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Behav. 1988;15:351–77.CrossRef
19.
go back to reference Green J, Willis K, Hughes E, Small R, Welch N, Gibbs L, Daly J. Generating best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health. 2007;31:545–50.CrossRefPubMed Green J, Willis K, Hughes E, Small R, Welch N, Gibbs L, Daly J. Generating best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health. 2007;31:545–50.CrossRefPubMed
20.
go back to reference Criss S, Woo Baidal JA, Goldman RE, Perkins M, Cunningham C, Taveras EM. The Role of Health Information Sources in Decision-Making Among Hispanic Mothers During Their Children’s First 1000 Days of Life. Matern Child Health J. 2015;19:2536–43.CrossRefPubMedPubMedCentral Criss S, Woo Baidal JA, Goldman RE, Perkins M, Cunningham C, Taveras EM. The Role of Health Information Sources in Decision-Making Among Hispanic Mothers During Their Children’s First 1000 Days of Life. Matern Child Health J. 2015;19:2536–43.CrossRefPubMedPubMedCentral
21.
go back to reference Stengel MR, Kraschnewski JL, Hwang SW, Kjerulff KH, Chuang CH. “What my doctor didn’t tell me”: examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Women’s Health Issues. 2012;22:e535–40.CrossRefPubMedPubMedCentral Stengel MR, Kraschnewski JL, Hwang SW, Kjerulff KH, Chuang CH. “What my doctor didn’t tell me”: examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Women’s Health Issues. 2012;22:e535–40.CrossRefPubMedPubMedCentral
22.
go back to reference Herring SJ, Nelson DB, Davey A, Klotz AA, Oken E, Foster GD. Determinants of excessive gestational weight gain in urban, low-income women. Women’s Health Issues. 2012;22:e439–46.CrossRefPubMedPubMedCentral Herring SJ, Nelson DB, Davey A, Klotz AA, Oken E, Foster GD. Determinants of excessive gestational weight gain in urban, low-income women. Women’s Health Issues. 2012;22:e439–46.CrossRefPubMedPubMedCentral
23.
go back to reference Duthie EA, Drew EM, Flynn KE. Patient-provider communication about gestational weight gain among nulliparous women: a qualitative study of the views of obstetricians and first-time pregnant women. BMC Pregnancy Childbirth. 2013;13:231.CrossRefPubMedPubMedCentral Duthie EA, Drew EM, Flynn KE. Patient-provider communication about gestational weight gain among nulliparous women: a qualitative study of the views of obstetricians and first-time pregnant women. BMC Pregnancy Childbirth. 2013;13:231.CrossRefPubMedPubMedCentral
24.
go back to reference Stotland NE, Haas JS, Brawarsky P, Jackson RA, Fuentes-Afflick E, Escobar GJ. Body mass index, provider advice, and target gestational weight gain. Obstet Gynecol. 2005;105:633–8.CrossRefPubMed Stotland NE, Haas JS, Brawarsky P, Jackson RA, Fuentes-Afflick E, Escobar GJ. Body mass index, provider advice, and target gestational weight gain. Obstet Gynecol. 2005;105:633–8.CrossRefPubMed
25.
go back to reference Oken E, Switkowski K, Price S, Guthrie L, Taveras EM, Gillman M, Friedes J, Callaghan W, Dietz P. A qualitative study of gestational weight gain counseling and tracking. Matern Child Health J. 2013;17:1508–17.CrossRefPubMedPubMedCentral Oken E, Switkowski K, Price S, Guthrie L, Taveras EM, Gillman M, Friedes J, Callaghan W, Dietz P. A qualitative study of gestational weight gain counseling and tracking. Matern Child Health J. 2013;17:1508–17.CrossRefPubMedPubMedCentral
26.
go back to reference Campbell F, Johnson M, Messina J, Guillaume L, Goyder E. Behavioural interventions for weight management in pregnancy: a systematic review of quantitative and qualitative data. BMC Public Health. 2011;11:491.CrossRefPubMedPubMedCentral Campbell F, Johnson M, Messina J, Guillaume L, Goyder E. Behavioural interventions for weight management in pregnancy: a systematic review of quantitative and qualitative data. BMC Public Health. 2011;11:491.CrossRefPubMedPubMedCentral
27.
go back to reference Chang T, Llanes M, Gold KJ, Fetters MD. Perspectives about and approaches to weight gain in pregnancy: a qualitative study of physicians and nurse midwives. BMC Pregnancy Childbirth. 2013;13:47.CrossRefPubMedPubMedCentral Chang T, Llanes M, Gold KJ, Fetters MD. Perspectives about and approaches to weight gain in pregnancy: a qualitative study of physicians and nurse midwives. BMC Pregnancy Childbirth. 2013;13:47.CrossRefPubMedPubMedCentral
28.
go back to reference Stotland NE, Gilbert P, Bogetz A, Harper CC, Abrams B, Gerbert B. Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling? J Women’s Health. 2010;19:807–14.CrossRef Stotland NE, Gilbert P, Bogetz A, Harper CC, Abrams B, Gerbert B. Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling? J Women’s Health. 2010;19:807–14.CrossRef
29.
go back to reference Mills A, Schmied VA, Dahlen HG. ‘Get alongside us’, women’s experiences of being overweight and pregnant in Sydney, Australia. Matern Child Nutr. 2013;9:309–21.CrossRefPubMed Mills A, Schmied VA, Dahlen HG. ‘Get alongside us’, women’s experiences of being overweight and pregnant in Sydney, Australia. Matern Child Nutr. 2013;9:309–21.CrossRefPubMed
30.
go back to reference Herring SJ, Platek DN, Elliott P, Riley LE, Stuebe AM, Oken E. Addressing obesity in pregnancy: what do obstetric providers recommend? J Women’s Health. 2010;19:65–70.CrossRef Herring SJ, Platek DN, Elliott P, Riley LE, Stuebe AM, Oken E. Addressing obesity in pregnancy: what do obstetric providers recommend? J Women’s Health. 2010;19:65–70.CrossRef
31.
go back to reference Stewart ZA, Wallace E, Allan C. Weight gain in pregnancy: a survey of current practices in a teaching hospital. Aust N Z J Obstet Gynaecol. 2012;52:208–10.CrossRefPubMed Stewart ZA, Wallace E, Allan C. Weight gain in pregnancy: a survey of current practices in a teaching hospital. Aust N Z J Obstet Gynaecol. 2012;52:208–10.CrossRefPubMed
32.
go back to reference O’loughlin J, Makni H, Tremblay M, Lacroix C, Gervais A, Déry V, Meshefedjian G, Paradis G. Smoking cessation counseling practices of general practitioners in Montreal. Prev Med. 2001;33:627–38.CrossRefPubMed O’loughlin J, Makni H, Tremblay M, Lacroix C, Gervais A, Déry V, Meshefedjian G, Paradis G. Smoking cessation counseling practices of general practitioners in Montreal. Prev Med. 2001;33:627–38.CrossRefPubMed
33.
go back to reference Rogers LQ, Gutin B, Humphries MC, Lemmon CR, Waller JL, Baranowski T, Saunders R. Evaluation of internal medicine residents as exercise role models and associations with self-reported counseling behavior, confidence, and perceived success. Teach Learn Med. 2006;18:215–21.CrossRefPubMed Rogers LQ, Gutin B, Humphries MC, Lemmon CR, Waller JL, Baranowski T, Saunders R. Evaluation of internal medicine residents as exercise role models and associations with self-reported counseling behavior, confidence, and perceived success. Teach Learn Med. 2006;18:215–21.CrossRefPubMed
Metadata
Title
A qualitative study of gestational weight gain goal setting
Authors
Shaniece Criss
Emily Oken
Lauren Guthrie
Marie-France Hivert
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-1118-2

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