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Obstetrician and Gynecologist’s Perspectives on the Definition and Management of Obesity in Pregnancy
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- Author / Creator
- Stafford, Shawna M
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Introduction: Obesity is a complex disease affecting increasing numbers of reproductive aged
women. Despite ongoing research efforts, many knowledge gaps remain when caring for
women with obesity in pregnancy. Currently, there is no clearly defined, comprehensive
standard of care for pregnant women with obesity. Consequently, obstetricians and gynecologists (OBGYNs) have developed different approaches. In this study, how the management of women with obesity differs from that of normal weight patients was explored. Another aim was to gain a better understanding of how OBGYNs define obesity, as there is currently no consensus definition.Methods: A mixed methods approach was used. Qualitative concept maps were generated
through individual in-depth mapping sessions with seven OBGYNs and analyzed
thematically. Major themes informed survey development. The resultant survey was
distributed to OBs in Edmonton (n=58). Responses were entered into a Research Electronic
Data Capture Database (REDCap) and descriptive statistics performed. Finally, semi-structured interviews with residents in obstetrics and gynecology were conducted until saturation about the current working definition and ideal definition of obesity in pregnancy. Ethics approval was obtained.Results/Conclusions: Obstetrics and Gynecology residents and staff physicians relied on varying subjective measures to classify patients as having obesity or not. They defined and appreciated risk secondary to obesity at different Body Mass Index (BMI) points. While they found it useful, BMI was not routinely used and on its own was felt to be insufficient to define obesity. Clinicians prefer a definition of obesity that incorporates a more comprehensive picture of patient health and wellbeing. This could include medical comorbidities and specific barriers to care that may provide insight into weight distribution. Establishing a consensus definition and classification of obesity in pregnancy would allow for more standardized care plans to be developed.
Limited professional education opportunities, lack of specific counseling tools, time constraints, and negative bias toward women with obesity in pregnancy all act as barriers to providing evidence-based care to women with obesity. Education strategies addressing these barriers will help empower obstetrical care providers to become champions of weight management in the future. Current guidelines do not address many of the areas physicians identify as challenging and important in the care of women with obesity in pregnancy. Revision of national guidelines should incorporate those areas OBGYNs deem most crucial to providing high level care. -
- Subjects / Keywords
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- Graduation date
- Fall 2019
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- Type of Item
- Thesis
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- Degree
- Master of Science
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- License
- Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.