Prenatal Weight Gain: Who is Counseled?
Prenatal Weight Gain: Who is Counseled?
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DOI：
10.1089/jwh.2011.2922
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发表时间：
2012-06-01
影响因子：
3.5
通讯作者：
Gerbert, Barbara
中科院分区：
文献类型：
--
作者：
Stotland, Naomi;Tsoh, Janice Y.;Gerbert, Barbara
背景：由于产前咨询与体重增加指南的依从性有关，我们试图确定在产前护理期间接受体重增加、营养和运动咨询的患者水平特征。方法：我们对一组参加产前咨询干预研究的妇女进行了二次数据分析。在多变量分析中，我们控制了研究组分配（干预与常规护理）以及患者特征。我们进行了三个独立的多变量分析，以预测医患之间关于(1)体重增加、(2)营养和(3)锻炼的讨论。结果：该队列包括311名主要低收入产前患者，在旧金山湾区的几个地点接受护理。孕前体重指数、营养知识、母亲年龄、胎次和保险类型与接受有关体重增加、营养和运动的咨询没有显著相关。在多变量分析中，白人女性接受营养咨询的可能性明显低于非白人女性（p = 0.02）。戒烟者比不吸烟者更容易接受营养和运动方面的咨询（p < 0.05）。孕龄越早，体重增加的咨询率越高（p = 0.01）。结论：尽管在全国范围内，白人女性体重过度增加的比例最高，但她们在怀孕期间接受营养咨询的可能性最低。干预措施，促使临床医生和简化咨询可能提高咨询率为所有患者在产前护理。
Background: Because prenatal counseling is associated with adherence to weight gain guidelines, we sought to identify patient-level characteristics associated with the receipt of counseling on weight gain, nutrition, and exercise during prenatal care.Methods: We performed a secondary data analysis on a cohort of women enrolled in a prenatal counseling intervention study. We controlled for study group assignment (intervention versus usual care) as well as patient characteristics in a multivariable analysis. We performed three separate multivariable analyses for predictors of provider-patient discussions about (1) weight gain, (2) nutrition, and (3) exercise.Results: The cohort consisted of 311 predominantly low-income prenatal patients receiving care at several sites in the San Francisco Bay Area. Prepregnancy body mass index, nutrition knowledge, maternal age, parity, and type of insurance were not significantly associated with receipt of counseling about weight gain, nutrition, and exercise. In the multivariable analysis, white women were significantly less likely to be counseled about nutrition than non-white women (p = 0.02). Former smokers were more likely to receive counseling about nutrition and exercise than never smokers (p < 0.05). More advanced gestational age was associated with a higher rate of counseling on weight gain (p = 0.01).Conclusions: Despite having the highest rates of excessive weight gain nationally, white women were the least likely to receive counseling about nutrition during pregnancy. Interventions that prompt clinicians and simplify counseling may improve counseling rates for all patients during prenatal care.