Stephanie Mattfeld Beaudette M'Ed', RD

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Stephanie Mattfeld Beaudette M.Ed., RD Colorado
Department of Public Health and Environment CDC
Preconception Summit June 21-23, 2005
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Inadequate Prenatal Weight Gain and Low Birth
Weight in Colorado

• In 2002, there were 68,420 births
• nearly 1 in 4 of pregnant women gained
  inadequately
• 16,000 pregnant women in 2002!
• 6,116 low birth weight births
• 1,180 LBW births can be attributed to inadequate
  prenatal weight gain (19.3 PAR)

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Colorados Social Marketing Campaign to Address
Inadequate Prenatal Weight GainA Healthy Baby
is Worth the Weight
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Campaign Purpose Goals

• Increase the number of pregnant women in Colorado
  who gain an adequate amount of weight during
  pregnancy.
• Decrease the number of low birth weight births in
  Colorado due to inadequate prenatal weight gain.

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Campaign Evaluation

• Goals
• To increase adequate weight gain among pregnant
  women in Colorado.
• Ultimately, to decrease low birth weight births
  in Colorado.
• How will we achieve these goals?
• Motivate prenatal health care providers to
  discuss and monitor appropriate weight gain with
  patients.
• Increase awareness about the importance of
  maternal weight gain among consumers.

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Campaign Evaluation

• Added a question to the 2004 PRAMS survey
• How much weight did your doctor, nurse or other
  health care worker tell you to gain during your
  pregnancy?
• ______ Pounds OR ______ Kilos
• They did not tell me how much weight to gain
• I dont remember
• Other, please tell us _________________________

• Colorado birth certificate (2006) added fields
• pre-pregnancy weight
• height

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Campaign Process
Initial consumer and provider Focus groups
Advertising agency selected
Materials created, tested and revised
Campaign promotion next steps!
Media Campaign
Provider Training
Web site
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Issues for Women in Addressing Inadequate Weight
Gain Issues

• Pregnant Women Focus Group Results, Summer 2002
• Concern about body image during pregnancy-fear of
  becoming overweight
• Reported lack of education from health care
  providers, especially doctors
• Questioned relationship between maternal weight
  gain and infant weight and health

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The women I know arent gaining They need to
know how important it is to gain. I know three
pregnant women who have pictures of models on the
inside of their kitchen cupboards so when they
open the cupboard they dont eat so much. The
Hollywood stars give a false impression of what a
pregnant lady should look like.
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Issues for Physicians in Addressing Inadequate
Weight Gain

• FP OB/GYN Physician Focus Group Results, Spring
  2001
• Skeptical about the impact of IWG on the number
  of low birth weight births
• Lack of knowledge/training in nutrition
• Lack of resources to provide intervention
• Medicalization of issue (ultrasound)

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Roll Out to the Medical CommunityFebruary-Septemb
er 2004

• Provided MCH grant funds to several large local
  health departments to support a campaign
  coordinator within the agency
• Adapted a Train-the-Trainer approach for county
  wide training
• Collected data on number of providers trained,
  material evaluation, change in practice, etc.

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1990 Institute of Medicines Total Weight Gain
Recommendations

• Low BMI (lt19.8) 28-40 pounds
• Normal BMI (19.8-26) 25-35 pounds
• High BMI (26-29) 15-25 pounds
• Obese BMI (gt29) 15 pounds
• Based on pre-pregnancy weight height