Evidence-based Practice Proposal

To Explore the Effects of Physical Activity and Diet Interventions on body weight among obese or overweight women during pregnancy and six weeks postpartum

Research Problem 

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The study will explore the effects of physical activities and diet changes on body weight among obese and overweight women during pregnancy and six weeks postpartum. The reason for choosing this research issue is due to the increased obesity rates in the United States, which have doubled in the last four decades. 

Research Context

Choi, Fukuoka, and Lee, (2014) explain that obesity or overweight among pregnant women exposes them to the risk of type 2 diabetes, cardiovascular diseases, and long-term obesity. The issue of pre-pregnancy obesity and overweight is on the rise where more than a third of pregnant women are either obese or overweight. 

The Background of the Issue

According to Singh and DiBari (2019), approximately 40% of women in the U.S. and 38% of men are obese, while 70% of the total population in the U.S. is overweight. In particular, the rate of pre-pregnancy obesity has increased from 17.6% in 2003 to 20.5% in 2018 (U.S. Department of Health and Human Services, 2018). Singh and Dibari (2019) identifies that women who are obese or overweight during pregnancy are likely to retain the added weight even after birth

Impact of Pre-Pregnancy Obesity on Patient’s Outcome

Pre-pregnancy obesity among mothers as acknowledged by Declercq et al., (2016) increases complications during pregnancy and giving birth, like miscarriage, stillbirth, induced labor, dysfunctional and prolonged labor, cesarean section, gestational hypertension, preeclampsia, gestational diabetes, preterm birth, fetal macrosomia,  infant mortality, and select birth defects. 

Significance of Pregnancy Obesity on Nursing 

It is the nurse’s responsibility to improve the health of pregnant women by tackling and managing the issue of obesity and overweight during pregnancy and the first six weeks postpartum. 

Proposed Solution 

Nurses should train obese and overweight pregnant women on nutrition and physical activity recommendations during pregnancy and after giving birth based on their BMI. One aspect is the type of food to eat, the amount of energy intake, and the significance of healthy eating. In the aspect of exercise, pregnant and postpartum women should have moderate activity, staying fit with exercise, and maintain a regular regime.

Question Development

To Explore the Effects of Physical Activity and Diet Interventions on body weight among obese or overweight women during pregnancy and six weeks postpartum

How do pregnant women with obesity or overweight (P) prefer physical activity (I) and dietary interventions (C) to reduce body weight (O) during pregnancy and six weeks postpartum (T)? 

Literature Source Selection

  1. Farpour-Lambert, Ells, Martinez de Tejada and Scott (2018)

The article follows a systematic review and meta-analyses to explore obesity and weight in pregnancy and postpartum where it provides the risk rate gestational obesity (50%) and the risk of premature deaths (35%). The strategy provided is a gradual return to exercise immediately after birth. 

  1. Denison et al., (2018)

The article identifies obesity as a serious health problem among pregnant women, which approximately affects 47.3% of women (BMI above normal). Obesity during pregnancy risks the mother and the child to adverse health outcome and provides several strategies to tackle the issue. 

  1. Poston et al., (2015)

The authors identify that obesity is widespread in high-income countries and affects 1 in 5 pregnant women where it causes adverse health effects. The article also stipulates prevention strategies. 

  1. Singh and DiBari (2019)

This article is of significance as it provides the dramatic obesity rates among pregnant women (27.5%) and highlights that obesity is likely to cause deaths and complication both to the child and the mother.

  1. Declercq et al., (2016)

Provides the increasing rate of obesity, the mortality rate of infants from obese mothers (1.42 odds ratio), and focuses on IOM recommendations

  1. Buschur and Kim (2014)

The article provides the guidelines for obesity during pregnancy and first explores the rate of pre-pregnancy obesity and complications.

  1. Aşcı and Rathfisch (2016)

The article provides that 70.7% of women in Turkey are obese or overweight. Besides, obesity causes complications to the mother and the child and is preventable through lifestyle interventions

  1. Chen, Xu, and Yan (2018)

Identifies the global burden of overweight and obesity among pregnant women, the rate, the morbidity and mortality burden, and the strategies to solve the issue

Conclusion

Obesity and overweight among pregnant and breastfeeding mothers are high and exposes the women at risk of maternal and infant adverse outcomes. However, nurses can educate women to eat healthy and maintain moderate exercise regimes during pregnancy and after giving birth. 

References

Aşcı, Ö., & Rathfisch, G. (2016). Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial. Journal of Health, Population, and Nutrition35(1). doi: 10.1186/s41043-016-0044-2

Buschur, E., & Kim, C. (2012). Guidelines and interventions for obesity during pregnancy. International Journal Of Gynecology & Obstetrics119(1), 6-10. doi: 10.1016/j.ijgo.2012.04.025

Chen, C., Xu, X., & Yan, Y. (2018). Estimated global overweight and obesity burden in pregnant women based on panel data model. PLOS ONE13(8), e0202183. doi: 10.1371/journal.pone.0202183

Choi, J., Fukuoka, Y., & Lee, J. (2013). The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: A systematic review and meta-analysis of randomized controlled trials. Preventive Medicine56(6), 351-364. doi: 10.1016/j.ypmed.2013.02.021

Declercq, E., MacDorman, M., Cabral, H., & Stotland, N. (2016). Prepregnancy Body Mass Index and Infant Mortality in 38 U.S. States, 2012–2013. Obstetrics & Gynecology127(2), 279-287. doi: 10.1097/aog.0000000000001241

Denison, F., Aedla, N., Keag, O., Hor, K., Reynolds, R., Milne, A., & Diamond, A. (2018). Care of Women with Obesity in Pregnancy. BJOG: An International Journal Of Obstetrics & Gynaecology126(3), e62-e106. doi: 10.1111/1471-0528.15386

Farpour-Lambert, N., Ells, L., Martinez de Tejada, B., & Scott, C. (2018). Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies. Frontiers In Endocrinology9. doi: 10.3389/fendo.2018.00546

Poston, L., Bell, R., Croker, H., Flynn, A., Godfrey, K., & Goff, L. et al. (2015). Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. The Lancet Diabetes & Endocrinology3(10), 767-777. doi: 10.1016/s2213-8587(15)00227-2

Singh, G., & DiBari, J. (2019). Marked Disparities in Pre-Pregnancy Obesity and Overweight Prevalence among US Women by Race/Ethnicity, Nativity/Immigrant Status, and Sociodemographic Characteristics, 2012–2014. Journal Of Obesity2019, 1-13. doi: 10.1155/2019/2419263US Department of Health and Human Services. (2018). US Department of Health and Human Services. Healthy People 2020. Retrieved from http://www.healthypeople.gov/2020/default.aspx

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