Protocol - Serial Pregnancy Weight - Weights Abstracted from Prenatal Charts

Description:

Serial measures of weight either (1) abstracted from health care (prenatal) records or (2) measured prospectively for the duration of gestation. Data collected entail (1) weights measured at all prenatal visits; (2) dates of all prenatal visits; (3) reported pre-pregnancy weight; (4) reported or measured height; and (5) gestational age at every prenatal visit and at delivery. If the opportunity exists to collect the gestational weight prospectively as part of the research protocol, this is preferred because weights taken using a research protocol are better standardized for amount of participant clothing and scales are regularly calibrated.

Protocol:

Weights Abstracted from Prenatal and/or Labor and Delivery Charts

Most obstetric practices and prenatal clinics use a standardized form to chart prenatal course. The American Congress of Obstetricians and Gynecologists (ACOG, formerly the American College of Obstetricians and Gynecologists) has an Antenatal Record form that is periodically upgraded and available for its members. There are others, such as the POPRAS (Problem-Oriented Perinatal Risk Assessment System) or Hollister Maternal/Newborn Record System forms, which are also in common use. All of the standardized forms have places or spaces to report information on gestational age, pre-pregnancy weight, height, and weights measured during pregnancy at every prenatal visit and dates of examination, and these can be abstracted. For charts with only nurse/physician notes, measured weight should be recorded for each prenatal visit. For women carrying a singleton fetus, the expected schedule of prenatal visits suggested by ACOG is monthly through the 7th month (28 weeks), every 2-3 weeks through the 9th month (36 weeks), and weekly thereafter until delivery. Weight is occasionally measured at delivery and can be found in the labor and delivery chart along with the gestational age at delivery.

An example of the relevant section of the ACOG Antenatal Record Form B (Initial Physical Exam) which charts date of exam, pre-pregnancy weight, and height:

An example of the relevant section of the ACOG Antenatal Record Form C which contains the date of the woman’s last menstrual period (LMP) and estimated due date(s) (EDD) for establishing (or correcting) gestational age at each prenatal visit:

Gestational age (written with both weeks and days, e.g., 39 weeks and 0 days or 39 + 0) is calculated using the best obstetrical EDD based on the following formula:

Gestational Age = (280 - (EDD - Reference Date))/ 7

Protocol Name from Source:

American Congress of Obstetricians and Gynecologists (ACOG) Antenatal Form B and C

Availability:

Publicly available

Download PDF

Personnel and Training Required

For the aspects of the measures requiring chart review, the abstracter should be trained in medical terminology and records review; for measuring weights, the examiner should be trained as for Measured Weight.

Equipment Needs

Paper-and-pencil (for chart review) and/or digital scale or beam balance scale.

Requirements

Requirement Category	Required
Major equipment	No
Specialized training	No
Specialized requirements for biospecimen collection	No
Average time of greater than 15 minutes in an unaffected individual	No

Mode of Administration

Medical record abstraction

Life Stage:

Pregnancy

Participants:

Women who have had a pregnancy (20 weeks or longer) or are currently pregnant.

Specific Instructions:

None

Selection Rationale

Weight and weight gain in pregnancy are associated with adverse pregnancy outcomes, including risk for low and high birth weight (i.e., small-for-gestational age [SGA] and large-for-gestational age [LGA] newborns); risk for preeclampsia and gestational diabetes; and risk for cesarean delivery. Maternal weight gain below recommended is associated with a lower birth weight. Maternal weight gain in excess of recommendations is associated with a high birth weight and, especially among those women who were normal weight before pregnancy, has also been independently associated with risk of overweight and obesity in the offspring.

Language

English

Standards

Standard	Name	ID	Source
Common Data Elements (CDE)	Person Prenatal Chart Serial Pregnancy Weight Gain Weight Value	5021302	CDE Browser

Derived Variables

Total Weight Gain in Pregnancy, Rates of Weight Gain

Process and Review

The Expert Review Panel #1 reviewed the measures in the Anthropometrics, Diabetes, Physical Activity and Physical Fitness, and Nutrition and Dietary Supplements domains.

Guidance from the ERP includes:

• Added a new measure

New Data Dictionary

Source

American Congress of Obstetricians and Gynecologists (http://www.acog.org/)

General References

Institute of Medicine, Committee to Reexamine IOM Pregnancy Weight Guidelines. (2009). Weight gain during pregnancy: Reexamining the guidelines. K. M. Rasmussen & A. L. Yaktine (Eds.). Washington, DC: National Academy Press.

Rasmussen, K. M., Catalano, P. M., & Yaktine, A. L. (2009). New guidelines for weight gain during pregnancy: What obstetrician/gynecologists should know. Current Opinion in Obstetrics and Gynecology, 21, 521-526.

Protocol ID:

21701

Variables:

Export Variables

Variable Name	Variable ID	Variable Description	Version	dbGaP Mapping
PX021701_SerialWeights_Prenatal_Date_Visit_10	PX021701100100	What is the date of the tenth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_2	PX021701020100	What is the date of the second prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_3	PX021701030100	What is the date of the third prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_4	PX021701040100	What is the date of the fourth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_5	PX021701050100	What is the date of the fifth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_6	PX021701060100	What is the date of the sixth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_7	PX021701070100	What is the date of the seventh prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_8	PX021701080100	What is the date of the eighth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Date_Visit_9	PX021701090100	What is the date of the ninth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_10	PX021701100200	What is the patient's gestational age at the tenth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_2	PX021701020200	What is the patient's gestational age at the second prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_3	PX021701030200	What is the patient's gestational age at the third prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_4	PX021701040200	What is the patient's gestational age at the fourth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_5	PX021701050200	What is the patient's gestational age at the fifth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_6	PX021701060200	What is the patient's gestational age at the sixth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_7	PX021701070200	What is the patient's gestational age at the seventh prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_8	PX021701080200	What is the patient's gestational age at the eighth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_GestationalAge_Visit_9	PX021701090200	What is the patient's gestational age at the ninth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_10	PX021701100300	What is the patient's height at the tenth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_2	PX021701020300	What is the patient's height at the second prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_3	PX021701030300	What is the patient's height at the third prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_4	PX021701040300	What is the patient's height at the fourth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_5	PX021701050300	What is the patient's height at the fifth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_6	PX021701060300	What is the patient's height at the sixth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_7	PX021701070300	What is the patient's height at the seventh prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_8	PX021701080300	What is the patient's height at the eighth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Height_Visit_9	PX021701090300	What is the patient's height at the ninth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_InitialExamination_Date	PX021701010100	What is the date of initial examination	4	N/A
PX021701_SerialWeights_Prenatal_InitialExamination_Height	PX021701010200	What is the patient's height measured at initial examination?	4	N/A
PX021701_SerialWeights_Prenatal_InitialExamination_Weight	PX021701010300	What is the patient's weight measured at initial examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_10	PX021701100400	What is the patient's weight at the tenth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_2	PX021701020400	What is the patient's weight at the second prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_3	PX021701030400	What is the patient's weight at the third prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_4	PX021701040400	What is the patient's weight at the fourth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_5	PX021701050400	What is the patient's weight at the fifth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_6	PX021701060400	What is the patient's weight at the sixth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_7	PX021701070400	What is the patient's weight at the seventh prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_8	PX021701080400	What is the patient's weight at the eighth prenatal examination?	4	N/A
PX021701_SerialWeights_Prenatal_Weight_Visit_9	PX021701090400	What is the patient's weight at the ninth prenatal examination?	4	N/A

Research Domain Information

Measure Name:

Serial Pregnancy Weight Gain

Release Date:

October 1, 2015

Definition

Serial changes in weight of the participant during the course of pregnancy for the most recent pregnancy.

Purpose

Serial weights are used to assess patterns of weight gain over various periods, such as trimesters, and rates of weight gain, especially in the last two trimesters. Rates of weight gain are the only weight gain measures that are not dependent on a recalled or self-reported pre-pregnancy weight. Gestational weight gain and rates are generally interpreted based on a woman’s pre-pregnancy body mass index (BMI, kg/m²).

Keywords

Anthropometrics, weight, body mass index, BMI, gestation, ACOG