Healthy weight management during pregnancy: what advice and information is being provided

Background: Being overweight or obese during pregnancy increases the risk of maternal morbidity and mortality attributed to pregnancy-related complications and also poses risks to the baby. The present study explores the information and advice given to pregnant women of different prepregnancy body mass index (BMI) classifications.

Methods: Women with singleton pregnancies and members of the National Childbirth Trust were invited to take part in the study via either National Childbirth Trust antenatal classes or e-mail invitation. A questionnaire was developed to collect quantitative and qualitative data. The number of times that women from different BMI groups were weighed, whether weight gain, diet or exercise advice was received, as well as knowledge of weight gain recommendations was compared using Mann-Whitney U-tests and chi-squared tests. Qualitative data were analysed by thematic content analysis.

Results: Sixty women took part in the study with complete data set available for 59 of them. The majority of participants (84.1%) were weighed at least once during pregnancy; overweight/obese women were weighed significantly more times than those who were underweight/normal weight (P = 0.014). Only 25.4% of women received weight gain advice; 64.3% received diet/exercise advice from a healthcare source. No significant difference was found with respect to whether advice was received or not when comparing BMI groups. Underweight/normal weight women tended to underestimate, whereas those who were overweight or obese overestimated weight gain recommendations. Themes derived from the qualitative data were: weight gain advice wanted, diet and exercise advice wanted, lack of advice and support, and anxiety.

Conclusions: Advice women receive antenatally on weight gain, diet and exercise is brief and generally not related to weight management. Clearer, more detailed and personalised advice is wanted, particularly on weight gain. A lack of advice and support from healthcare professionals leads women to seek information for themselves from potentially un-regulated sources, and also to feelings of anxiety in some cases.