Pregnant Women with Obesity Have Unique Perceptions About Gestational Weight Gain, Exercise, and Support for Behavior Change
Pregnant Women with Obesity Have Unique Perceptions About Gestational Weight Gain, Exercise, and Support for Behavior Change
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DOI：
10.1111/jmwh.13094
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发表时间：
2020-06-18
影响因子：
2.7
通讯作者：
Mirabito, Ann M.
中科院分区：
文献类型：
--
作者：
Faucher, Mary Ann;Mirabito, Ann M.
孕前肥胖和过度孕期体重增加(GWG)对妇女和胎儿的健康构成威胁，然而孕期体重管理干预措施大多不成功。很少有研究调查肥胖女性对体重增加和锻炼的看法。尽管肥胖女性的身体习惯和生活经历不同，但大多数研究将超重和肥胖女性合并为一组。方法对肥胖孕妇进行3个焦点小组的调查，以确定孕妇对GWG、运动和行为干预的认知。结果17名妇女参加了焦点小组，其中6名在生育中心，11名在联邦合格的卫生中心。一项关键的发现是，肥胖女性感到被羞辱，并将怀孕视为逃避肥胖羞辱的避难所。参与者认为与GWG过多相关的风险被夸大了，相反，他们认为对自己感觉和外表的自我评估是更可靠的母婴健康衡量标准。参与者报告说，食物的质量而不是数量促进了怀孕健康，限制进食者将他们的胎儿置于危险之中。知识差距的出现与对体重增加指南的咨询不满意有关。尽管体育活动得到了支持，但参与者表达了对怀孕期间锻炼的安全担忧，转而支持步行和日常活动。目标设定、积极的信息传递和积极的强化被确定为拟议的行为干预的有利方面。讨论肥胖孕妇与其他孕妇一样，对怀孕期间的体重增加和运动有相同的看法，但也有独特的看法。在这项研究中，患有肥胖症的孕妇报告说，她们感到被羞辱，害怕被她们的医疗保健提供者羞辱，但矛盾的是，她们渴望得到指导。这一发现为这一人群的卫生保健咨询和全球工作组干预提供了启示。
Introduction Prepregnancy obesity and excessive gestational weight gain (GWG) pose health risks to woman and fetus, yet gestational weight management interventions are largely unsuccessful. Little research examines the perceptions of women with obesity about weight gain and exercise. Although women with obesity have different body habitus and life experiences, most studies combine overweight and obese women into one group. Methods We conducted 3 focus groups with pregnant women with obesity to determine perceptions of GWG, exercise, and a proposed behavioral intervention. Results Seventeen women participated in the focus groups including 6 at a birth center and 11 at a federally qualified health center. A key finding was that women with obesity felt stigmatized and perceived pregnancy as a refuge from fat shaming. Participants viewed risks associated with excessive GWG as exaggerated and instead deemed self-assessments of how they feel and look as more reliable measures of maternal and fetal health. Participants reported that quality rather than quantity of food promotes pregnancy health and that restrained eaters put their fetuses at risk. Knowledge gaps emerged related to dissatisfaction with counseling about weight gain guidelines. Although physical activity was endorsed, participants voiced safety concerns about exercise during pregnancy and instead favored walking and routine daily activity. Goal setting, positive messaging, and positive reinforcement were identified as favorable aspects of the proposed behavioral intervention. Discussion Pregnant women with obesity share other pregnant women's perceptions about weight gain and exercise in pregnancy but also have unique perceptions. Pregnant women with obesity in this study reported feeling stigmatized and fearful of being shamed by their health care providers but paradoxically eager for guidance. The findings offer implications for health care counseling and GWG interventions for this population.