| Objective(1)To understand the status of pregnant women’s weight gain during pregnancy and analyze the factors affecting weight management.(2)To explore the effect of mobile health interventions on weight management in pregnant women based on the Integrated Theory of Health Behavior Change(ITHBC).Methods(1)A total of 432 pregnant women in accordance to the inclusive and exclusive criteria in an outpatient prenatal examination in a tertiary Class A hospital in Zhenjiang were selected.The general situation questionnaire,the weight management knowledge and belief questionnaire,the General Self-efficacy Scales(GSES)and the Perceived Social Support Scale(PSSS)were used for the questionnaire survey.Conduct a questionnaire survey and collect the weight gain value of pregnant women during pregnancy,maternal and child pregnancy outcomes and other data,analyze the current status of weight gain during pregnancy and the factors affecting weight management.(2)A total of 110 pregnant women undergoing prenatal examinations in accordance to the inclusive and exclusive criteria in a tertiary Class A hospital in Zhenjiang City were selected,including 55 in the control group and 55 in the intervention group.The control group adopted routine methods for weight management during their pregnancy,and the intervention group implemented mobile health interventions based on the ITHBC theory based on the control group.The data of pregnant women’s weight gain during pregnancy,weight management knowledge and behavior,self-efficacy,comprehending social support and maternal and child pregnancy outcomes were compared.Results1.Status of pregnant women’s weight gain during pregnancy and its influencing factors(1)current status of weight gain during pregnancy: Among 432 pregnant women,the average weight gain during pregnancy was(16.18 ± 4.43)kg,of which excessive weight gain during pregnancy accounted for 45.8%.Among pregnant women with low BMI before pregnancy and normal pregnant women,the appropriate proportion of weight gain during pregnancy is large(71.0% and 51.5%),while among pregnant women with overweight BMI and obese before pregnancy,excessive weight gain during pregnancy is larger(80.0% and 87.5%).(2)Clinical outcomes of pregnant women and newborns: The average gestational week(38.90 ±1.26)weeks,234 cases(54.2%)of cesarean section,198 cases(45.8%)of natural delivery;26cases(12.9%)performed perineal resection and 172 cases(87.1%)who did not perform perineal resection;9 cases of postpartum hemorrhage(2.0%),423 cases(98.0%)without postpartum hemorrhage;202 cases of pregnancy complications(46.7%),and 230cases(53.3%)had no complications during pregnancy;52 cases of pregnancy with diabetes(12.1%),48 cases(11.2%)of pregnancy complicated with hypertension,and 12 cases(2.8%)of diabetes and hypertension.Of the 432 neonates,33 were large(7.7%),3 were neonatal asphyxia(0.7%),and 23 were premature(5.3%).(3)GESE score(2.47 ± 0.45)points;PSSS score(63.86 ± 11.27)points,including family support(23.12 ± 3.75),friend support(19.91 ± 4.17),other support(20.83 ± 4.34);weight management The survey results show that pregnant women’s correct perception of weight gain during pregnancy is low.At present,a large proportion of people do not take action on weight management during pregnancy.Among people who manage weight,the approach is simpler,only through diet or motion.(4)The results of single factor analysis of the factors influencing the weight gain of pregnant women during pregnancy show: Pregnant women of different ages,parity,pre-pregnancy BMI,education level,place of residence,self-efficacy,and comprehending social support have different weight gains during pregnancy(P <0.05).(5)Multiple stepwise regression analysis results show,influencing factors of weight gain during pregnancy:age,education,residence,parity,pre-pregnancy BMI,self-efficacy,and comprehending social support level can explain 52.4% variability.2.Application effect of mobile health intervention based on ITHBC theory in pregnant women’s weight management(1)Weight gain during pregnancy between the two groups of pregnant women:The total weight gain of pregnant women in the intervention group was lower than that in the control group(P<0.05).The appropriate rate of weight gain during pregnancy in the intervention group was higher than that in the control group(P <0.05).And the rate of excessive weight gain was lower than that of the control group(P <0.05).(2)Two independent sample t-test results show that at 28 weeks of pregnancy and 37 weeks ofpregnancy,pregnant women in the intervention group had higher self-efficacy and social support scores(P <0.05);Paired t-test results show that the pregnant women in the intervention group had significantly higher self-efficacy and social support scores at 28 and 37 weeks of pregnancy than those measured at the time of enrollment(P <0.05),the measurement scores of pregnant women in the control group were not statistically different(P> 0.05).Repeated measurement ANOVA results display that the two groups of pregnant women had statistically significant differences in self-efficacy and social support in time,between groups,and interaction effects(P<0.05).The results of the questionnaire on weight management of pregnant women show that at28 weeks of gestation,except for the method of controlling body weight during pregnancy,the other two groups were statistically different(P <0.05),at 37 weeks of gestation,the two groups of pregnant women had statistically significant differences in the measurements in each item(P<0.05).(3)Comparison of pregnancy outcomes between two groups of pregnant women:there was no statistically significant difference in the gestational weeks of delivery between pregnant women in the intervention group and control group(P> 0.05).The rate of cesarean section,the rate of perineal incision,the amount of bleeding at 2 hours postpartum,and the incidence of giant children in the intervention group were lower than those in the control group(P <0.05).Conclusion(1)At present,the incidence of excessive weight gain during pregnancy in this region is relatively high.Age,education,residence,parity,pre-pregnancy BMI,self-efficacy,and social support levels will affect the weight gain of pregnant women.(2)The implementation of a mobile health intervention program based on ITHBC theory can improve the self-efficacy of pregnant women and comprehend the level of social support,can effectively control the weight gain of pregnant women during pregnancy,can reduce the incidence of excessive weight gain during pregnancy,and can improve pregnancy outcomes. |
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