Providers use less patient-centered communication and give lower ratings of patient-provider relationships when providing prenatal care to overweight or obese women.
Why this matters
Increasing patient-centered communication, especially for patients who are overweight or obese, may improve prenatal care quality.
Researchers conducted a cross-sectional, secondary data analysis, using audio recordings, surveys, and medical records from prenatal visits between 22 providers and 117 of their patients at a single urban teaching hospital.
Multivariate, multilevel Poisson models were used to examine the relationship between patient prepregnancy BMI and provider communication.
Funding: National Institutes of Health.
Providers asked fewer lifestyle questions (incident rate ratio [IRR], 0.66; P=.04) and gave less lifestyle information (IRR, 0.51; P=.01) to overweight or obese patients.
Providers used fewer approval (IRR, 0.68; P=.01) and concern statements (IRR, 0.68; P=.002) when caring for overweight patients, and fewer self-disclosure statements caring for obese patients (IRR, 0.40; P=.02).
- Most providers were white female resident physicians, and the majority of patients were young black women or had Medicaid insurance; results may not be representative of practices in other settings.