Putting Prevention into Practice
An Evidence-Based Approach
Behavioral Counseling Interventions for Healthy Weight and Weight Gain in Pregnancy
Am Fam Physician. 2022 Feb ;105(2):187-188.
Author disclosure: No relevant financial relationships.
Case Study
A 23-year-old patient, J.J., presents to confirm pregnancy after a positive home pregnancy test result. The first day of the patient's last menstrual period was seven weeks ago. J.J. has no concerns, and blood pressure is 118/78 mm Hg on examination. J.J.'s medical records show a body mass index of 29 kg per m2 before the start of this pregnancy; J.J. has since gained 4 lb (1.81 kg). The rest of the patient's history and physical examination is unremarkable.
Case Study Questions
1. Based on the U.S. Preventive Services Task Force (USPSTF) recommendation, under which circumstance should physicians offer behavioral interventions to promote healthy weight gain and to prevent excess weight gain in pregnancy?
A. Only pregnant patients with a personal history of being overweight or having obesity should receive this counseling.
B. Only pregnant patients with a history of preeclampsia should receive this counseling.
C. All pregnant patients should receive this counseling.
D. Only pregnant patients with a history of gestational diabetes mellitus should receive this counseling.
E. All patients planning or capable of pregnancy should receive this counseling.
2. According to the USPSTF recommendation, what is the recommended gestational weight gain for this patient, assuming that J.J. has a singleton pregnancy?
A. 28 lb (12.7 kg) to 40 lb (18.14 kg).
B. 25 lb (11.34 kg) to 35 lb (15.88 kg).
C. 15 lb (6.8 kg) to 25 lb.
D. 11 lb (4.99 kg) to 20 lb (9.07 kg).
3. According to the USPSTF recommendation, which of the following approaches to behavioral counseling interventions to promote healthy weight gain during pregnancy are correct for this patient?
A. The patient does not need counseling because the body mass index does not exceed 30 kg per m2.
B. The patient should receive educational materials on healthy eating and ways to improve physical activity level.
C. The patient should receive counseling on healthy eating and physical activity, with multiple contacts throughout the pregnancy.
References
1. Davidson KW, Barry MJ, Mangione CM, et al. Behavioral counseling interventions for healthy weight and weight gain in pregnancy: US Preventive Services Task Force recommendation statement. JAMA. 2021;325(20):2087–2093.
2. Rasmussen KM, Yaktine AL, eds. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. National Academies Press; 2009.
3. Cantor AG, Jungbauer RM, McDonagh M, et al. Counseling and behavioral interventions for healthy weight and weight gain in pregnancy: evidence report and systematic review for the US Preventive Services Task Force [published correction appears in JAMA. 2021;326(11):1072]. JAMA. 2021;325(20):2094–2109.
This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/healthy-weight-and-weight-gain-during-pregnancy-behavioral-counseling-interventions.
This series is coordinated by Kenny Lin, MD, MPH, deputy editor.
A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.
Copyright © 2022 by the American Academy of Family Physicians.
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