Target Weight Program of Pregnancy for Improved Prenatal Care

Objective:

The Target Weight Program of Pregnancy can help pregnant women gain their  recommended  weight as outlined by the Institute of Medicine guidelines.

Design:

A randomized control trial was conducted to compare the outcomes of a motivational intervention entitled, the Target Weight Program of Pregnancy, and controls on prenatal weight gain.

Setting:

Participants were recruited from a hospital nurse-midwifery practice, family clinic, and health department clinic in thesouthwest.

Patients/Participants: Enrolled between 5-17 weeks gestation, singleton, without  medical complications. Randomization to intervention if enrolled on odd dates, control for even dates. N= 75.

Methods:

Intervention group received the Target Weight Program for Pregnancy with these key components:

• At first prenatal visit the Target Weight Flipchart is reviewed, risks and benefits of gaining the target weight are outlined.  Detailed nutrition information is included with a redesigned food and exercise pyramid for pregnancy, and culturally specific information.
• Motivational interviewing is done after the flipchart review,  and a target weight health contract signed by the client.  (These first two steps took an extra 10 minutes during appointments)
• A 72 hr diet recall sheet is assigned to complete for the following prenatal visits and results reviewed with their health care  provider

• At each return prenatal visit, their  weight is plotted on a weight gain grid.
• During subsequent visits, participants are praised for staying on target, and if not on target, motivational interviewing techniques employed to focus on achievable goal setting, and overcoming barriers to the recommendations of the program
• Satisfaction surveys for  intervention group were collected postpartum

Control participants received usual prenatal care.  

Results:  

The recommendations for weight gain in pregnancy outlined by the Institute of Medicine have health benefits for mom and baby. The Target Weight Program of Pregnancy is an intervention that has favorable outcomes in helping pregnant women achieve their  recommended weight gain.  It includes culturally specific nutrition and exercise education, motivational interviewing, positive reinforcement, and health care contracting.

A higher percentage of participants in the intervention group gained their target weight 50% vs. 38%. Of those who did not achieve their target weight, the number of pounds difference, or off-target was lower in the intervention group 2.14 # vs. 6.85 # per person.  Satisfaction scores were high for the program with many participants stating that the program helped them feel more in control of their pregnancy weight gain.

Conclusion/Implications for nursing practice:

Keywords: nutrition, weight gain, pregnancy, target weight