Title: Maternal Obesity Management: A Narrative Literature Review of health policies
Version: 6 Date: 10 Jun 2024
Reviewer's report:
I have reviewed the paper; however, there are some major and minor concerns.
Major Concerns:
1. Limited awareness and diverse country guidelines on maternal weight policies: The lack
of standardized guidelines across countries can lead to inconsistencies in care and potentially
suboptimal outcomes for pregnant women with obesity.
2. Lack of pre-pregnancy and postpartum weight guidelines in various countries: The absence of
specific guidelines for pre-pregnancy and postpartum weight management may result in missed
opportunities for intervention and support for women at different stages of their reproductive
journey.
3. Healthcare professionals facing barriers in weight management practices for maternal obesity
care: Barriers encountered by healthcare professionals can hinder the effective management of
maternal obesity, highlighting the need for targeted interventions and support systems.
4. Gaps in healthcare recommendations for managing maternal obesity and excessive gestational
weight gain: The lack of comprehensive recommendations for addressing maternal obesity and
excessive weight gain during pregnancy can impact the quality of care provided to pregnant
women.
5. Insufficient focus on maternal obesity as a policy target in certain regions like India: Regions
with limited focus on maternal obesity in health policies may miss opportunities to address this
significant public health issue effective.
6. Challenges in implementing specific recommendations for managing maternal obesity in
facility and community settings: Difficulties in translating recommendations into practice
settings can impede the delivery of evidence-based care for pregnant women with obesity.
7. Lack of evidence-based international guidelines for addressing maternal obesity and weight
management: The absence of standardized international guidelines may result in varying
practices and approaches to managing maternal obesity globally.
8. Need for global research on maternal weight management and policy impact assessment on
health outcomes: Research gaps in maternal weight management highlight the importance of
generating evidence to inform policies and interventions aimed at improving maternal and child
health outcomes.
9. Inadequate guidance for obstetricians and gynecologists in caring for pregnant women
with obesity: Healthcare providers may require additional training and resources to effectively
manage the unique needs and risks associated with maternal obesity.
10. Limited emphasis on modifiable risk factors for pregnant women with obesity: Addressing
modifiable risk factors is crucial for optimizing maternal and fetal health outcomes in women
with obesity during pregnancy.
11. Requirement for standardized clinical practice guidelines to enhance antenatal care for obese
pregnant women: Standardized guidelines can help ensure consistent and evidence-based care
for pregnant women with obesity, improving outcomes and reducing disparities in care.
12. Importance of education for women with BMI #30 on the impact of obesity on fertility,
pregnancy risks, and long-term health effects: Providing education and support to women with
obesity can empower them to make informed decisions about their health and well-being during
pregnancy and beyond.
13. Lack of robust evidence in many guidelines for managing maternal obesity, highlighting the
need for research to fill knowledge gaps: Research is essential to strengthen the evidence base
for managing maternal obesity and inform best practices in clinical care and policy development.
14. Inadequate integration of nutrition service packages for maternal obesity into routine
antenatal care in certain regions like India: Integrating nutrition services into routine care can
enhance the support available to pregnant women with obesity and promote healthy behaviors
during pregnancy.
15. Need for interventions aimed at facilitating behavior change among healthcare professionals
in managing maternal obesity: Supporting healthcare professionals in adopting evidence-based
practices and behavior change strategies is essential for improving the quality of care provided
to pregnant women with obesity.
16. Insufficient emphasis on the life course approach in connecting preconception, postpartum,
and interconception services for pregnant women with obesity: Taking a life course approach
can help address the continuum of care needs for women with obesity, promoting better health
outcomes for both mothers and children.
Minor Concerns:
1. Limited number of countries addressing maternal obesity in national health documents:
Countries with limited inclusion of maternal obesity in national health documents may miss
opportunities to prioritize and address this critical public health issue effectively.
2. Lack of guidelines targeting excessive gestational weight gain in national health documents:
The absence of specific guidelines for excessive gestational weight gain may result in inadequate
support for pregnant women at risk of complications related to weight gain during pregnancy.
3. Challenges in managing maternal obesity risks through counseling and pre-pregnancy weight
loss: Overcoming challenges in counseling and weight management interventions is essential
for supporting women with obesity in optimizing their health before and during pregnancy.
4. Inadequate support for pregnant women with obesity in terms of diet, exercise, and pregnancy
risk counseling: Providing comprehensive support in terms of diet, exercise, and counseling can
help pregnant women with obesity navigate the challenges and risks associated with their weight
status.
5. Varied approaches in national guidelines towards maternal weight management: Variability in
approaches across national guidelines may lead to inconsistencies in care and potentially impact
the quality of services provided to pregnant women with obesity.
6. Need for stronger evidence backing nutritional guidance, exercise, and pregnancy risk
counseling in guidelines: Strengthening the evidence base supporting nutritional guidance,
exercise recommendations, and risk counseling can enhance the effectiveness of interventions
for managing maternal obesity.
7. Lack of emphasis on the consequences of maternal obesity in certain regions: Regions with
limited emphasis on the consequences of maternal obesity may overlook the significant health
risks and implications associated with this condition.
8. Challenges in stakeholder mapping for managing maternal obesity in India: Identifying and
engaging stakeholders effectively is crucial for developing and implementing comprehensive
strategies to address maternal obesity in specific regions like India.
9. Limited availability of evidence-based clinical practice guidelines specific to obesity in
pregnancy: The availability of evidence-based guidelines specific to obesity in pregnancy is
essential for guiding clinical practice and ensuring optimal care for pregnant women with
obesity.
10. Insufficient focus on preventive recommendations for maternal obesity across pre-
pregnancy, pregnancy, and postpartum stages: Emphasizing preventive strategies across the
reproductive continuum is vital for addressing maternal obesity and its associated risks at
different stages of the maternal health journey.
11. Lack of comprehensive strategies for managing maternal obesity in global health policies:
Comprehensive strategies are needed in global health policies to address the multifaceted
challenges posed by maternal obesity and promote optimal maternal and child health outcomes.
12. Inadequate attention to the long-term health effects of maternal obesity on both mother
and child: Considering the long-term health implications of maternal obesity is essential for
developing holistic interventions that address the health needs of both mothers and their children.
13. Challenges in implementing policies and programs to manage maternal obesity effectively:
Overcoming implementation challenges is crucial for translating policies and programs into
actionable strategies that effectively address maternal obesity and improve health outcomes.
14. Need for standardized approaches in maternal weight management to ensure consistent care
for obese pregnant women: Standardized approaches can help streamline care delivery, enhance
consistency in practice, and improve outcomes for pregnant women with obesity across different
healthcare settings.