Prenatal care quality suffers for overweight patients

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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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).

Limitations

  • 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.