No global consensus: a cross-sectional survey of maternal weight policies

BMC Pregnancy and Childbirth

Barbara Abrams⁴  Katharina C Quack Loetscher¹  Lucilla Poston²  Ellen A Nohr³  Francisco Mardones⁶  Natali Valdez⁵  Christopher T Andersen⁷  Courtney Scott⁷ 

[1] Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland;Division of Women’s Health, King’s College London, St Thomas’ Hospital, London, UK;Department of Public Health, Aarhus University, Aarhus, Denmark;103 Haviland Hall, Berkeley, CA 94720, USA;Department of Anthropology, University of California, Irvine, Irvine, CA, USA;Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile;Berkeley School of Public Health, University of California, Berkeley, CA, USA

关键词: International;    Key informant;    Maternal weight policies;   

Others  :  1127340
DOI  :  10.1186/1471-2393-14-167

 received in 2013-12-06, accepted in 2014-04-25,  发布年份 2014

【 摘 要 】

Background

Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines.

Methods

This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight.

Results

Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known.

Conclusions

These results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child.

【 授权许可】

   
2014 Scott et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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