Obstetrician and Gynecologist’s Perspectives on the Definition and Management of Obesity in Pregnancy
Notice bibliographique
Résumé
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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».