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Gestational weight gain

      Prenatal care providers are advised to evaluate maternal weight at each regularly scheduled prenatal visit, monitor progress toward meeting weight gain goals, and provide individualized counseling if significant deviations from a woman’s goals occur. Today, nearly 50% of women exceed their weight gain goals with overweight and obese women having the highest prevalence of excessive weight gain. Risks of inadequate weight gain include low birthweight and failure to initiate breast-feeding whereas the risks of excessive weight gain include cesarean deliveries and postpartum weight retention for the mother and large-for-gestational-age infants, macrosomia, and childhood overweight or obesity for the offspring. Prenatal care providers have many resources and tools to incorporate weight and other health behavior counseling into routine prenatal practices. Because many women are motivated to improve health behaviors, pregnancy is often considered the optimal time to intervene for issues related to eating habits and physical activity to prevent excessive weight gain. Gestational weight gain is a potentially modifiable risk factor for a number of adverse maternal and neonatal outcomes and meta-analyses of randomized controlled trials report that diet or exercise interventions during pregnancy can help reduce excessive weight gain. However, health behavior interventions for gestational weight gain have not significantly improved other maternal and neonatal outcomes and have limited effectiveness in overweight and obese women.

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      References for motivational interviewing

      Books

        • Miller W.R.
        • Rollnick S.
        Motivational interviewing: preparing people for change.
        2nd ed. Guilford Press, New York (NY)2002
        • Rollnick S.
        • Miller W.R.
        • Butler C.
        Motivational interviewing in health care: helping patients change behavior.
        Guilford Press, New York (NY)2008

      Videos

        • Miller W.R.
        Motivational interviewing.
        University of New Mexico, Albuquerque (NM)1989 (Available from the author at the Department of Psychology, University of New Mexico, Albuquerque, NM 87131; (505) 277-4121)
        • Hester R.K.
        • Handmaker N.S.
        Motivating pregnant women to stop drinking.
        Behavior Therapy Associates, Albuquerque (NM)1997 (Available from Behavior Therapy Associates, 9426 Indian School Rd NE, Suite 1, Albuquerque, NM 87112; (505) 345-6100)

      Online

      1. Motivational Interviewing Network of Trainers (MINT) is an international organization of trainers in motivational interviewing. Their central interest is to improve the quality and effectiveness of counseling and consultations with clients about behavior change. There is a calendar of available 2-day training sessions, some of which are offered on-line. Available at: http://www.motivationalinterviewing.org/about_mint

      2. Health Sciences Institute motivational interviewing training for health care. Available at: http://www.healthsciences.org/Motivational-Interviewing-Health-Coach-Training.

      Journals

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        • Lindhardt C.L.
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        Midwifery. 2015; 31: 678-684
        • Rollnick S.
        • Butler C.C.
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        • Gregory J.
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        Motivational interviewing.
        BMJ. 2010; 340: c1900