OBSTETRICS
Assessing the Accuracy of Pregnant Women in Recalling Pre-Pregnancy Weight and Gestational Weight Gain

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Abstract

Objective

Maternity care providers can use pre-pregnancy weight (PPW) and gestational weight gain (GWG) as markers for difficult delivery, and frequently obtain this information directly from the patient. The goal of this study was to determine whether women report their PPW and GWG correctly at the end of pregnancy.

Methods

We performed a prospective cohort study of 189 women delivering between June 1,2011, and July 31,2011, at the Saint John Regional Hospital or the Moncton Hospital in New Brunswick. Self- reported PPW and GWG were compared with measured weights obtained from the antenatal chart and upon presentation for delivery. Patient characteristics, BMI classification, and accuracy and degree of error in recall were assessed.

Results

The majority of respondents were under 30 years of age (63.4%) and were delivering at term (96.3%). Ninety women (47.6%) were having their first baby. A record of weight measured in the first trimester was available for 98 respondents (51.9%); using this information, 44 women (44.9%) were determined to be overweight or obese at delivery. Approximately one third of women with a normal BMI were not able to recall their PPW or GWG accurately (± 1 kg). Among all BMI classes, there was a consistent pattern of under-reporting of PPW (by a mean of 1.52 kg) and over-reporting of GWG (by a mean of 1.61 kg), but several extreme outliers were identified.

Conclusion

At the time of delivery, under-reporting of PPW and over-reporting of GWG are common and difficult to predict. Maternity care providers should be aware of this discrepant reporting of PPW and GWG and recognize the implications for intrapartum management and postpartum weight loss.

Résumé

Objectif

Les fournisseurs de soins de maternité peuvent utiliser le poids prégrossesse (PPG) et le gain pondéral gestationnel (GPG) à titre de marqueurs pour ce qui est de l’accouchement difficile; de plus, ils peuvent fréquemment obtenir cette information directement de la patiente. Cette étude avait pour objectif de déterminer si les femmes signalent leur PPG et leur GPG correctement à la fin de la grossesse.

Méthodes

Nous avons mené une étude de cohorte prospective auprès de 189 femmes ayant accouché entre le 1er juin 2011 et le 31 juillet 2011, au Saint John Regional Hospital ou au Moncton Hospital au Nouveau-Brunswick. Le PPG et le GPG autosignalés ont été comparés aux mesures du poids issues du dossier prénatal et effectuées à l’arrivée de la patiente à l’hôpital pour l’accouchement. Les caractéristiques de la patiente, la classification IMC et la précision et le degré d’erreur en ce qui concerne le signalement des poids ont été évalués.

Résultats

La majorité des répondantes avaient moins de 30 ans (63,4 %) et accouchaient à terme (96,3 %). Quatre-vingt-dix femmes (47,6 %) en étaient à leur premier accouchement. Le poids mesuré au cours du premier trimestre avait été consigné en ce qui concerne 98 répondantes (51,9 %); en fonction de ces données, nous avons déterminé que 44 femmes (44,9 %) présentaient une surcharge pondérale ou étaient obèses au moment de l’accouchement. Près du tiers des femmes présentant un IMC normal n’étaient pas en mesure de se rappeler de leur PPG ou de leur GPG avec précision (± 1 kg). Dans toutes les classes d’IMC, nous avons constaté une tendance stable quant au sous-signalement du PPG (de 1,52 kg, en moyenne) et au sursignalement du GPG (de 1,61 kg, en moyenne); cependant, plusieurs valeurs extrêmement aberrantes ont été identifiées.

Conclusion

Au moment de l’accouchement, le sous-signalement du PPG et le sursignalement du GPG sont courants et difficiles à prédire. Les fournisseurs de soins de maternité devraient prendre conscience de ces divergences quant signalement du PPG et du GPG, et en reconnaître les conséquences en matière de prise en charge intrapartum et de perte de poids postpartum.

Section snippets

INTRODUCTION

In New Brunswick, as in other regions of Canada, pregnant women are often asked for their pre-pregnancy weight and gestational weight gain when they are admitted for delivery. To the best of our knowledge, the validity of this self-reported information has not been assessed in Canada. We hypothesized that the majority of pregnant women do not accurately report their PPW and GWG at the time of delivery. Since this information is used by care providers to assess and anticipate potential for

METHODS

We developed a prospective cohort consisting of all women presenting to Saint John Regional Hospital and The Moncton Hospital for delivery of a term (≥ 37 weeks) pregnancy between June 1, 2011, and July 31, 2011. At the time of admission for delivery, women were asked by the admitting nurse to provide their PPW and GWG. Height and weight were measured by the nurse using a stadiometer and calibrated digital weight scale to determine end-of-pregnancy BMI. The self-reported answers were then

RESULTS

A total of 189 women were included in the cohort and in the analysis. Patient characteristics are described in Table 1. The majority of patients were under 30 years of age and were having their first or second baby. Slightly more than one half (98; 51.9%) had a measured weight recorded before the end of the first trimester (12+6 weeks’ gestation). Gestational age at delivery was 37 to 42 weeks (i.e., at term) in 182 women (96.3%). Women having their second baby were more likely to have a higher

DISCUSSION

This study showed that many women in this New Brunswick cohort self-reported PPW and GWG values that were discrepant from those measured and recorded in their chart when they were asked to report these variables at the time of delivery. We have also confirmed an apparent deficiency in measuring first-trimester weights in these women, as 48.1% of women did not have this value recorded in their chart. We were able to use the recorded first-trimester weight as a surrogate for PPW because

CONCLUSION

The results of our study suggest that, at the time of delivery, women commonly misreport PPW and GWG, a finding that seems to be BMI class dependent. The importance of appropriate gestational weight gain for BMI class and the importance of active living should be discussed with all patients. Pre-pregnancy weight should be measured and recorded, and, if this is not possible, a measured first-trimester weight should be substituted. Gestational weight gain should be meticulously measured and

REFERENCES (12)

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Competing Interests: None declared.

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