Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2023

What stops women from engaging with referrals for gestational weight gain (GWG)? (97687)

Jenna Hollis 1 2 3 , Gabriella Gallardo 3 , Justine Daly 1 2 3 , Eva Farragher 1 2 3 , Belinda Tully 1 4 5 , Michelle Foster 6 , Craig Pennell 3 , John Attia 3 , Edwina Dorney 7 , Christophe Lecathelinais 1 , Karen Campbell 8 , John Wiggers 1 2 3 , Melanie Kingsland 1 2 3
  1. Hunter New England Population Health, Newcastle, NSW, Australia
  2. Population Health Research Group, Hunter Medical Research Institute, Newcastle, NSW, Australia
  3. College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
  4. Gomeroi Nation, New England North West, NSW, Australia
  5. Armajun Aboriginal Health Service, Inverell, NSW, Australia
  6. Hunter New England Local Health District Nursing and Midwifery Services, Newcastle, NSW, Australia
  7. Centre for Population Health, New South Wales Ministry of Health, Sydney, NSW, Australia
  8. Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia

Introduction: GWG within recommended ranges is associated with improved maternal and child health outcomes, including reduced risk of obesity. Pregnancy Care Guidelines recommend that women with GWG outside of recommendations be offered a referral to a dietitian. In New South Wales (NSW), referral to the Get Healthy in Pregnancy (GHiP) telephone service is also recommended for all women. Evidence regarding offer and uptake of GWG referrals is limited. This study reports: the frequency of GWG referral offer, acceptance and engagement; associations with maternal and maternity service characteristics; and reason/s for not accepting or engaging with referrals.

Method: We conducted telephone/online surveys with women attending public maternity services in one health district in NSW (August 2020-December 2022). Women’s self-reported GWG, referral receipt and reasons for not accepting or engaging were reported using descriptive statistics. Multi-variable logistic regression analyses examined associations between referral outcomes and maternal and maternity service characteristics.

Results: We received 8517 surveys. Most women (69%) reported GWG outside recommendations. Only 15% were offered a referral, and 66% of these women accepted. Women with gestational diabetes (OR:3.99; 95%CI:2.37-6.71; p<0.001) and receiving care from a doctor (OR:2.68; 95%CI:1.41-5.08; p<0.023) had higher odds of accepting. Common reasons for declining a referral were: support not needed (63%) and no time (15%). Of women who accepted a referral, 76% had engaged with the service. Women with gestational diabetes (OR:1.96; 95%CI:1.16-3.32; p<0.012) had higher odds of engaging with the referral. Common reasons for not engaging were: not able to take call (23%), no contact to make appointment (12%) and support not needed (12%).

Conclusions: Few women were offered a GWG referral and most did not agree support was needed. This evidence can inform service-wide practice change initiatives to support antenatal care providers to improve the offer, acceptance and engagement of GWG referrals by pregnant women.