Don't underestimate the importance of patient counseling.
"WE ARE STRUGGLING with an obesity epidemic in this country, and pregnancy accounts for a risk time for women to gain excessive weight," Martina L. Badell, MD, said in an interview. "This is a very well-designed large study which attempted to systematically evaluate the adverse perinatal outcomes associated with inappropriate weight gain in pregnancy across a diverse group of women."
Dr. Badell said she was not surprised by the results because they support findings from previous studies and reflect "what we as clinicians taking care of patients see on a regular basis."
She emphasized that "the take-home message is the importance of counseling regarding weight gain in pregnancy and monitoring it closely in real time as the associated risks are significant and potentially avoidable. The first step to solving a problem is adequately quantifying it, and this study does just that. The next step is giving this information to pregnant women along with making weight gain a part of the discussion prior to pregnancy and at every prenatal visit."
Dr. Badell added, "Ideally, the weight gain for an individual pregnant women would be tracked and discussed with her during each prenatal visit. If she is below or above the recommendations, the risks associated with this could be discussed along with strategies to get/stay on track. In an ideal world, women struggling with weight gain goals in pregnancy would have access to a dietitian. However, in reality, ob.gyn. offices will likely need to come up with patient education handouts or staff education."
Another useful avenue for research would be assessing the effects of patient education, Dr. Badell said. "The next best step would be implementing a study to assess if education of women during pregnancy about their individual weight gain at each visit and discussion regarding perinatal risks affects ultimate weight gain and reduces risks.
Additionally, education could begin in the preconception phase as this knowledge is likely important even prior to pregnancy. Finally, studies are needed on interventions such as working with dietitians or patient education classes once a woman has been identified as not being within weight-gain goals to evaluate if these can alter weight gain and improve outcomes."
Dr. Badell is a maternal-fetal medicine specialist in the department of gynecology and obstetrics at Emory University, Atlanta. She was asked to comment on the findings of Kominiarek et al. Dr. Badell had no relevant financial conflicts to disclose.
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|Title Annotation:||VIEW ON THE NEWS|
|Publication:||OB GYN News|
|Date:||Nov 1, 2018|
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