Patient-reported gestational weight gain care provided by general practitioners: a cross-sectional study

Australian clinical practice guidelines recommend all pregnant people receive routine antenatal care for gestational weight gain (GWG). All antenatal care providers (ACP) including general practitioners (GP) are recommended to assess weight and provide advice on recommended GWG, physical activity and dietary intake at every antenatal visit. Pregnant people gaining weight outside of recommendations are to be offered a referral for additional support. However, a 2018-19 Australian study found less than 10% of pregnant people report receiving recommended care. GPs are an important provider of early antenatal care, yet there is limited evidence on their provision of guideline care. This study examines pregnant people’s reported receipt of GP-provided antenatal care for GWG, and characteristics of pregnant people associated with receipt of recommended care. Between January-July 2021, cross-sectional telephone and online surveys were conducted with pregnant people who had recently attended 14 public maternity service sites for antenatal care in one health district in New South Wales, Australia. Pregnant people self-reported their characteristics and receipt of recommended GWG care by GPs before entry to public maternity services. Receipt of care, and its association with participant characteristics, were examined using descriptive statistics and logistic regression analyses. Of 1880 participants, 22.9% reported receipt of assessment and 17.1% reported receipt of advice, with 12.5% receiving both elements. Just 3.8% reported being offered a referral. Pregnant people who identified as Aboriginal and/or Torres Strait Islander (OR = 3.50; 95%CI:1.66–7.38), had a pre-pregnancy BMI categorised as overweight (OR = 1.68; 95%CI:1.16–2.43), were in their first pregnancy (OR = 1.90; 95%CI: 1.35–2.67) and lived in inner regional Australia (OR = 1.88; 95%CI:1.31–2.70) had higher odds of receiving recommended care (both assessment and advice). Pregnant people living in inner regional Australia (OR = 2.61; 95%CI:1.42–4.80) or outer regional/remote Australia (OR = 2.85; 95%CI:1.25–6.49) had higher odds of being offered a referral. Most pregnant people did not report receiving guideline-recommended GWG care by their GP before entry to public maternity services. Care was inconsistently provided and differed by pregnant people’s characteristics; associations require confirmation in studies with provider-level and service-level data. There may be a need for practice-change strategies to support GPs to provide recommended care for GWG.