Gestational Weight Gain Clinical Trial
Official title:
MANAGEMENT OF GESTATIONAL WEIGHT GAIN BY FAMILY PHYSICIANS: SEEKING CONGRUENCE WITH GUIDELINES
Background The Institute of Medicine (IOM) published guidelines in 2009 for optimal
gestational weight gain (GWG) during pregnancy. These guidelines include trajectories for
optimal GWG, based on a woman's pre-pregnancy body mass index (BMI), to be used throughout
the duration of a pregnancy. Although there is a significant association between the total
GWG recommended by these guidelines and maternal and perinatal outcomes, research has
demonstrated that only approximately one-third of pregnant women have total GWG within the
recommended amounts. Factors known to influence GWG include maternal age, parity, being in a
committed relationship and smoking. In addition, recommendations by primary care providers
have been shown to influence actual GWG. Women appreciate advice from their primary care
providers, however, despite this, there is evidence that many patients report not being
advised at all about GWG by their primary care providers.
Relevance Excess weight gain in pregnancy has been shown to be a modifiable risk factor for
excess weight in childhood, thus contributing to the intergenerational cycle of obesity.
There is an opportunity to interfere with this cycle during the peri-pregnancy period, as
women's motivation to engage in behaviour change is elevated and contact with their primary
care providers is frequent.
Research Question and Hypothesis What impact does training family physicians to regularly
refer to the IOM trajectories and provide feedback about GWG ("training in the use of IOM
charts") during routine prenatal visits, compared to usual care, have on congruence of total
GWG with IOM guidelines? Null Hypothesis: there is no difference in the congruence of total
GWG with IOM guidelines between women whose family physicians were assigned to training in
the use of the IOM charts and those whose family physicians were assigned to usual care.
Objectives
The following are the objectives for this study:
1. To compare the congruence of total GWG with IOM guidelines between women whose family
physicians were assigned to training in the use of IOM trajectories and those whose
family physicians were assigned to usual care.
2. To explore the relationship between other independent variables (maternal age, parity,
committed relationship and smoking) and congruence of total GWG with IOM guidelines, for
women whose family physicians were assigned to training in the use of IOM trajectories
and for those whose family physicians were assigned to usual care.
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