JMIR Publications

ABSTRACT

Background:

Maternal weight gain during pregnancy is one of the few potentially modifiable risk factors for many adverse maternal and child health outcomes. Defining optimal pregnancy weight gain ranges is difficult because while lower weight gain may prevent some outcomes, such as maternal and child obesity, it may increase the risk of others, such as fetal growth restriction and infant death. These health outcomes vary in their seriousness to mothers and their health-care providers, and these differences in seriousness should be taken into account when determining optimal weight gain ranges. However, the relative seriousness that women and their care providers place on different health outcomes is unknown.

Objective:

We will determine the seriousness of 11 maternal and child health outcomes that have been consistently associated with pregnancy weight gain. We will achieve this by engaging patients and maternal and child health professionals using an online modified-Delphi panel process.

Methods:

We will recruit a racially/ethnically and geographically diverse group of 90 U.S. maternal and child health professionals and 90 women who are pregnant or less than 2 years postpartum. We will conduct 3 concurrent panels using the ExpertLens system—a previously evaluated online modified-Delphi system that combines two rounds of rating with a round of feedback and moderated online discussion. In Round 1, panelists will be asked to rate the seriousness of each health outcome on a scale of 0 to 100 and to provide a rationale for their scores. In Round 2, panelists will review their responses relative to those of other panelists. They will discuss their seriousness ratings anonymously using a moderated online discussion board. In Round 3, participants will revise their Round 1 responses based on group feedback and discussion. Each round will be open 1 to 2 weeks.

Results:

The study protocol was reviewed by our ethics boards and was determined to be not human subject research. A pilot study of 6 professionals and 6 patients has been completed. The projected study completion date is December 2019.

Conclusions:

Our numeric estimates of the seriousness of maternal and child health outcomes will enable future studies to determine pregnancy weight gain ranges that balance the risks of low and high weight gain for mothers and children.