Obstetricians and maternal body weight and eating disorders during pregnancy

Intrauterine growth restriction (IUGR) is associated with maternal prepregnancy body mass index (BMI), body weight gain during pregnancy and smoking, eating and weight-losing behaviors. The aim of this pilot study was to examine the practices of obstetricians to determine whether more can be done to prevent IUGR and 'do no harm' to the body image of women during pregnancy. Obstetricians (n = 67) who reported delivering an average of 125 babies in the previous year completed a questionnaire that enquired about their antenatal practice of maternal weighing, history taking and referral of pregnant women. No doctor calculated the prepregnancy BMI. Women (90%) were weighed during some or all antenatal visits, usually by the nurse-receptionist, but one-third of the obstetricians did not refer to these body weight records. Most obstetricians asked women about their cigarette smoking and alcohol intake before pregnancy, and during pregnancy discussed supplements and nausea and vomiting. Fewer than 50% of doctors asked about depression, body weight control and disordered eating. One-third of doctors were not aware of having seen a woman with an eating disorder in the previous year. Obstetricians who asked about eating disorders were more likely to ask about depression, and obstetricians in private practice were significantly less likely to ask women about a history of depression and to refer women to a psychologist or psychiatrist Obstetricians could improve antenatal care by asking about body weight and calculating prepregnancy BMI, and investigating weight-losing behavior and psychological or psychiatric problems such as eating disorders.