TY - JOUR
T1 - Modeling the predictive value of evidence-based referral criteria to support healthy Gestational Weight Gain among an Australian pregnancy cohort
AU - Fealy, Shanna
AU - Hollis, Jenna
AU - Martin, Julia
AU - Leigh, Lucy
AU - Oldmeadow, Christopher
AU - Collins, Clare E.
AU - Smith, Roger
AU - Wilkinson, Shelley
AU - Hure, Alexis
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/1/17
Y1 - 2022/1/17
N2 - Globally, there has been a renewed focus on addressing gestational weight gain (GWG). In Australia, the Department of Health pregnancy care guidelines recommend women be offered routine weighing and receive brief nutritional and physical activity support during antenatal care visits. Women gaining weight outside the Institute of Medicine (IOM)’s weight gain reference values are further recommended to be referred to a dietitian. However, professional and organizational barriers, including an absence of weight gain referral pathways and limited workforce resources, exist with the translation and scaling of these recommendations into practice. This study aimed to explore patterns of GWG among a cohort of Australian pregnant women and to determine if pregnancy weight gains of above or below 2 kg or 5 kg in the second and third trimester can be used to predict total GWG outside recommendations. Sensitivity, specificity, negative, and positive likelihood ratios were calculated. The most predictive time point was 24 weeks’ gestation using the minimum weight change parameter of +/−2 kg, demonstrating reasonable sensitivity (0.81, 95% CI 0.61–0.83) and specificity (0.72, 95% CI 0.61–0.83), resulting in 55% (n = 72/131) of the cohort qualifying for dietetic referral. Given the current health service constraints, a review of dietetic services within maternity care is warranted.
AB - Globally, there has been a renewed focus on addressing gestational weight gain (GWG). In Australia, the Department of Health pregnancy care guidelines recommend women be offered routine weighing and receive brief nutritional and physical activity support during antenatal care visits. Women gaining weight outside the Institute of Medicine (IOM)’s weight gain reference values are further recommended to be referred to a dietitian. However, professional and organizational barriers, including an absence of weight gain referral pathways and limited workforce resources, exist with the translation and scaling of these recommendations into practice. This study aimed to explore patterns of GWG among a cohort of Australian pregnant women and to determine if pregnancy weight gains of above or below 2 kg or 5 kg in the second and third trimester can be used to predict total GWG outside recommendations. Sensitivity, specificity, negative, and positive likelihood ratios were calculated. The most predictive time point was 24 weeks’ gestation using the minimum weight change parameter of +/−2 kg, demonstrating reasonable sensitivity (0.81, 95% CI 0.61–0.83) and specificity (0.72, 95% CI 0.61–0.83), resulting in 55% (n = 72/131) of the cohort qualifying for dietetic referral. Given the current health service constraints, a review of dietetic services within maternity care is warranted.
KW - Antenatal care
KW - Dietitian
KW - Gestational weight gain
KW - Maternal nutrition
KW - Pregnancy
KW - Referral
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U2 - 10.3390/nu14020381
DO - 10.3390/nu14020381
M3 - Article
C2 - 35057562
AN - SCOPUS:85122808021
VL - 14
JO - Nutrients
JF - Nutrients
SN - 2072-6643
IS - 2
M1 - 381
ER -