Improving Gestational Weight Gain Counseling Through Meaningful Use of an Electronic Medical Record

Lindberg, Sara M.; Anderson, Cynthie K.

doi:10.1007/s10995-014-1467-2

Cited by 18 publications

(33 citation statements)

References 23 publications

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“…According to a retrospective chart review before and after the intervention, the rate of GWG counseling in agreement with the 2009 IOM guidelines improved (2.6% before vs. 51% after, p<0.001) among obstetrician-gynecologists, family medicine physicians, and certified nurse midwives. 54 These results were encouraging, but additional research is needed to determine how interfaces with the EMR and GWG counseling can translate into improved patient outcomes.…”

Section: Practical Approaches To Assist Providers and Patients In Meementioning

confidence: 94%

Gestational weight gain

Kominiarek

Peaceman

2017

American Journal of Obstetrics and Gynecology

315

259

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Prenatal care providers are advised to evaluate maternal weight at each regularly scheduled prenatal visit, monitor progress toward meeting weight gain goals, and provide individualized counseling if significant deviations from a woman’s goals occur. Today, nearly 50% of women exceed their weight gain goals with overweight and obese women having the highest prevalence of excessive weight gain. Risks of inadequate weight gain include low birth weight and failure to initiate breastfeeding whereas the risks of excessive weight gain include cesarean deliveries and post-partum weight retention for the mother and large for gestational age infants, macrosomia, and childhood overweight or obesity for the offspring. Prenatal care providers have many resources and tools they can use to incorporate weight and other health behavior counseling into their routine prenatal practices. Because many women are motivated to improve their health behaviors, pregnancy is often considered the optimal time to intervene for issues related to eating habits and physical activity so as to prevent excessive weight gain. Gestational weight gain is a potentially modifiable risk factor for a number of adverse maternal and neonatal outcomes and meta-analyses of randomized controlled trials report that diet or exercise interventions during pregnancy can help reduce excessive weight gain. However, health behavior interventions for gestational weight gain have not significantly improved other maternal and neonatal outcomes and have limited effectiveness in overweight and obese women.

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Section: Practical Approaches To Assist Providers and Patients In Meementioning

confidence: 94%

Gestational weight gain

Kominiarek

Peaceman

2017

American Journal of Obstetrics and Gynecology

315

259

View full text Add to dashboard Cite

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“…This study involved secondary analysis of data from an intervention that improved provider behavior surrounding gestational weight gain patient education (Lindberg & Anderson, 2014). The original sample contained 388 participants who received prenatal care at one of five participating clinics before implementation of the intervention, in 2011, and 345 participants who received prenatal care at the same clinics after implementation of the intervention, in 2012.…”

Section: Methodsmentioning

confidence: 99%

“…The project was reviewed and approved as exempt by the University of Wisconsin-Madison Health Sciences Institutional Review Board as a quality improvement initiative. Additional details on development of the intervention and its effects on provider behavior can be found elsewhere (Lindberg & Anderson, 2014). …”

Section: Methodsmentioning

confidence: 99%

“…This tool improved the rate of antenatal gestational weight gain counseling that was consistent with current IOM guidelines (p < 0.001) across all provider types, including obstetricians, family practice physicians, and certified nurse midwives. (Lindberg & Anderson, 2014). Gestational weight gain patient education is correlated with patients’ internalized gestational weight gain goals and actual gestational weight gain, and those who receive no patient education are more likely to gain weight outside guidelines (Herring, Nelson, et al, 2012; Tovar et al, 2011).…”

mentioning

confidence: 99%

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Effect of a Best Practice Alert on Gestational Weight Gain, Health Services, and Pregnancy Outcomes

Lindberg

DeBoth

Anderson

2016

Matern Child Health J

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Objective To examine whether an electronic medical record “best practice alert” previously shown to improve antenatal gestational weight gain patient education resulted in downstream effects on service delivery or patient health outcomes. Methods This study involved secondary analysis of data from an intervention to improve provider behavior surrounding gestational weight gain patient education. Data were from retrospective chart reviews of patients who received care either before (N=333) or after (N=268) implementation of the intervention. Pre-post comparisons and multivariable logistic regression were used to analyze downstream effects of the intervention on health outcomes and obesity-related health services while controlling for potential confounders. Results The intervention was associated with an increase in the proportion of prenatal patients who gained weight within Institute of Medicine guidelines, from 28% to 35% (p < .05). Mean total gestational weight gain did not change, but variability decreased such that post-intervention women had weight gains closer to their gestational weight gain targets. The intervention was associated with a 94 gram decrease in mean infant birth weight (p = .03), and an increase in the proportion of overweight and obese women screened for undiagnosed Type 2 diabetes before 20 weeks gestation, from 13% to 25% (p = .01). Conclusions for Practice The electronic medical record can be leveraged to promote healthy gestational weight gain and early screening for undiagnosed Type 2 diabetes. Yet most patients still need additional support to achieve gestational weight gain within Institute of Medicine guidelines.

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“…16 Obstetrical practice is changing to address these guidelines, and data suggest that meeting IOM guidelines does improve pregnancy outcomes. [16][17][18][19] Changes in obstetrical practice may also influence offspring growth patterns. However the influence of obstetrical changes on pediatric outcomes remains largely unexamined.…”

Section: Introductionmentioning

confidence: 99%

Infant Growth following Maternal Participation in a Gestational Weight Management Intervention

et al. 2016

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Background: Obesity is widespread and treatment strategies have demonstrated limited success. Changes to obstetrical practice in response to obesity may support obesity prevention by influencing offspring growth trajectories.Methods: This retrospective cohort study examined growth among infants born to obese mothers who participated in Nutrition in Pregnancy (NIP), a prenatal nutrition intervention at one urban hospital. NIP participants had Medicaid insurance and BMIs of 30 kg/m

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Improving Gestational Weight Gain Counseling Through Meaningful Use of an Electronic Medical Record

Cited by 18 publications

References 23 publications

Gestational weight gain

Gestational weight gain

Effect of a Best Practice Alert on Gestational Weight Gain, Health Services, and Pregnancy Outcomes

Infant Growth following Maternal Participation in a Gestational Weight Management Intervention

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