16 Jul Gestational Weight Gain Related Outcomes According to Health Care Provider
Background: This study examined whether type of antenatal health care provider (HCP) (family physician, obstetrician, midwife, family physician + obstetrician) was associated with differing rates of excess or inadequate gestational weight gain (GWG) and associated adverse outcomes including large for gestational age (LGA), small for gestational age (SGA), cesarean section, preterm birth. Methods: This retrospective cohort study used data from the Better Outcomes Registry & Network, 2012-2016, for singleton hospital births at 20-42 weeks in Ontario, Canada. Descriptive statistics were calculated to summarize patient characteristics and outcomes by HCP. Crude and adjusted relative risks (RR) with 95% confidence intervals (CIs) were calculated for the exposure, GWG relative to each secondary outcome by HCP. Population attributable fractions (PAFs) with 95% CIs were calculated to assess the proportion of secondary outcomes that could be prevented if GWG not meeting the recommendation were removed by antenatal HCP. Results: Rates of GWG below, within, or above recommendations were 13.7%, 31.0% and 55.3% respectively and did not differ across HCP groups. No difference was observed in rates of secondary outcomes according to GWG across HCPs. Excess GWG was associated with a significant risk for LGA and cesarean, inadequate GWG was associated with an increased risk of SGA and PTB. The PAFs indicated a pronounced contribution of excess GWG to LGA across all HCP groups. Interpretation: GWG and rates of secondary outcomes associated with GWG did not differ according to antenatal HCP. A significant proportion of LGA, SGA, cesarean could be prevented with appropriate GWG.
Contact for this study:
Maisah Syed, firstname.lastname@example.org