Healthcare related barriers and enablers for weight management among pregnant women with overweight and obesity: a rapid scoping review

Background: Overweight and obesity in pregnancy are associated with health risks for women and babies. Providing effective weight management during pregnancy is necessary to support appropriate gestational weight gain and improve outcomes for women and their infants. This study aimed to synthesise evidence documenting healthcare-related barriers and enablers for weight management among pregnant women with overweight or obesity in English-speaking high-income countries. 

Methods: An initial rapid scoping review focusing on the healthcare-related barriers and enablers for weight management in all populations with overweight or obesity was undertaken. Due to the unique weight management needs of pregnant women, this study analysed a sub-set of publications collected in the initial review pertaining to pregnant women. All publication types (except protocols and conference abstracts) were eligible for inclusion. The search was limited to publications from 2010 onwards. Academic and grey literature were identified, screened, and data extracted. Findings were summarised thematically. 

Results: The initial review search, including all populations, identified 12,762 unique abstracts, and 181 full-text articles. Of these, 22 focused on pregnant women living with overweight or obesity. A further four articles were identified via citation searches of the included articles. The identified barriers and enablers for pregnancy weight management in healthcare settings fell under three broad themes: (1) access to, and engagement with, weight management advice during pregnancy (2), challenges for providing weight management support in healthcare settings, and (3) healthcare provider confidence in providing weight management advice during pregnancy. 

Conclusion: Pregnant women with overweight or obesity are not receiving adequate weight management guidance. Multi-level strategies are needed to ensure pregnant women have access to weight management care that is stigma-free, easily accessible, tailored to their individual needs and fosters positive relationships with healthcare providers.