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Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain

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In a significant effort to improve preventive care, a team of researchers developed and validated a screening questionnaire to identify pregnant women at risk for excessive gestational weight gain (GWG). This project, a cooperation between the TU Munich and EFCNI, found some relevant risk factors for GWG, and created a questionnaire to accurately identify people at risk for GWG. Despite the promising results, more research in this area is encouraged.

Excessive gestational weight gain (GWG) during pregnancy has been linked to some adverse health outcomes for the mother and the child, such as obesity or diabetes. However, there are not many tools for identifying women at risk at an early stage, as this would involve considering individual risk factors, which can be challenging. Led by Professor Hans Hauner, a group of researchers, including the research department of EFCNI, aimed to create a practical questionnaire that doctors, nurses, and midwives could use during prenatal visits to identify at-risk patients for excessive GWG, thus improving prevention rates for GWG.

This new study was a secondary analysis of the German GeliS (“Gesund leben in der Schwangerschaft”/”healthy living during pregnancy”) study, which had the objective of improving health factors such as the pre- and postnatal lifestyle of participants. Potential risk factors such as age, lifestyle etc., were used first to establish the screening questionnaire. Additionally, data from the FeLIPO (“Feasibility of lifestyle-intervention in pregnancy to optimise maternal weight development”) study, a previous pilot study of the GeliS, also served to validate the questionnaire. For further validation, the data of over 1,700 pregnant women pooled from both studies were considered to ensure the questionnaire’s accuracy and effectiveness in identifying at-risk individuals.

Six variables were found to be associated with excessive GWG: higher pre-pregnancy Body Mass Index (BMI), intermediate educational level, nulliparity, being born in a country outside Germany, having smoked at any point, and signs of a depressive disorder. The results of the analysis also showed that, with the help of the self-reported data on sociodemographics, anthropometrics, smoking behaviour, and mental health status, the questionnaire was effective in predicting which women would gain excessive weight during pregnancy. The scoring system of the questionnaire also facilitates the classification into different risk categories, allowing for more accuracy.

Researchers believe that by identifying women at risk, healthcare providers can implement timely interventions, such as personalised counselling, nutritional guidance, and physical activity recommendations, to prevent or mitigate excessive GWG during pregnancy.

More research in this area is encouraged to make sure this questionnaire works well for different countries, cultures, and ethnicities. For now, researchers hope that this proactive approach will effectively reduce risks such as gestational diabetes, preeclampsia, caesarean section, and postpartum weight retention, thus promoting healthier pregnancies and improving the well-being of women and children worldwide.

 

Paper available at: BMC Pregnancy and Childbirth

Full list of authors: Kristina Geyer, Roxana Raab, Julia Hoffmann, and Hans Hauner.

DIO: https://doi.org/10.1186/s12884-023-05569-7