Provider advice about pregnancy weight gain and adequacy of weight gain

Most pregnant women continue to gain weight outside Institute of Medicine (IOM) recommendations. Few studies have explored the role of provider advice on achieving targeted weight gains. We used data from a longitudinal pregnancy cohort study to examine the association between provider advice and gestational weight gain. Women with singleton live births and weight gain data were included (n=1,454). Women reported provider advice about weight gain in a telephone interview at 27-30 weeks' gestation. Adequacy of gestational weight gain was defined using the 1990 Institute of Medicine (IOM) guidelines, accounting for gestational age. Linear regression and generalized linear modeling (GLM) were used to estimate the adjusted risks of inadequate or excessive gain associated with provider advice. The majority of women (78%) gained outside IOM recommendations and most (65%) gained excessively; mean weight gain was 15.3 kg, SD 6.1kg. Just over half reported receiving weight gain advice from a health care provider. In the linear regression analysis, a change from no advice to receiving advice resulted in an adjusted estimate of 0.46 kg (1.01 lb, p>0.05) decrease in total pregnancy weight gain. GLM estimates showed virtually no effect of provider advice on inadequate or excessive gain. In contrast to earlier studies, our results do not support an association between provider advice and pregnancy weight gain. However, the collective findings of earlier studies suggest that advice is an important influence on women's behavior; thus greater effort is needed to better understand the particular nature of provider advice about healthy pregnancy weight gain.