The Impact of Maternal Weight during Pregnancy on Child’s and Mother’s Health in the Future

Recent years are characterized by an increase of interest in the impact of maternal weight on mother’s and child’s health, the attempts of reconsideration of the earlier known factors on the basis of new methodological fundamentals, and in the new achievements of fundamental medicine, biology and, respectively, the science of nutrition. An appropriate, healthy, and balanced nutrition of a mother during pregnancy provides a normal course of the fetus development, pregnancy, childbirth, the post-delivery recovery, and the post-natal development of a child. The nutritional factor and the weight control play key role during the pre-natal and post-natal development of a mother and a child. Both quantitative (insufficient or superfluous caloric consumption) and qualitative (the unbalanced ration of proteins, fats, carbohydrates, mineral substances, and vitamins) unbalanced nutrition leads to severe complications of pregnancy (gestosis, premature delivery, anemia) and childbirth (the anomaly of the patrimonial activity, patrimonial traumatism), to the delay in the development of a fetal fetus, and to the pathology of a newborn. Thus, the purpose of the study is to analyze the impact of the maternity weight during pregnancy on child’s and mother’s health in the future.

Independent and Dependent Variables

Independent variables include the control of body weight, which is the ratio of consumed fats, proteins, and carbohydrates. The dependent variable is the impact of the maternal weight on health of a mother and a child in the future.

Definition of Terms

Pregnancy is a special state of woman’s organism, when an embryo develops in her reproductive organs. Pregnancy appears in result of conjugation of female and male germ cells in the uterine, so that zygote, which contains 46 chromosomes, is formed.

Maternal weight is the weight of a pregnant woman and it changes during the pregnancy. The maternal weight can be normal, excessive, or low.

Research Question

Does maternal weight during pregnancy have an impact on child’s or mother’s health in the future?

Research Tasks

1. To study the features of the course of pregnancy, childbirth, and post-natal state of woman’s health and the condition of a newborn child as well as the state of a fetus and a newborn in case of insufficient and superfluous food consumption;
2. To assess the maternity weight during all three pregnancy trimesters;
3. To reveal the consequences of the low and high maternity weight on health of a woman and a newborn in the post-natal development.

Theoretical Framework

Description of the Theoretical Framework

The fundamental principles of nursing process in the obstetric and gynecologic departments include comprehensive approaches, non-shared problems, and high quality as well as the succession of medical care in conditions of obstetric, therapeutic, and pediatric complex. The given research paper is based on theoretical framework that covers nursing theories, such as the theory of health promotion behavior and the theory of mother-infant attachment that allows answering the main research question by means of the existing nursing theories.

Identification of Concepts

The theory of health promotion behavior is focused on cognitive processes of an individual that precede any action related to health. However, it is important to remember the fact that decisions made by people about their actions are based on incentives, relations, and information from social, physical, and cultural environment. The theory of mother-infant connection represents a psychological model, which tries to describe the dynamics of short-term and long-term interpersonal relations. Newborn children display attachment through the motivational and behavioral system.

Rationale for Choosing Framework

Selected theories are used as a theoretical framework for future research, because the focus of the research is on nursing as well as on the mother-child physiological and psychological impact. The chosen theories contribute to the theoretical background of the given research.

Literature Review

Review of Scholarly Sources

Physiological course of pregnancy and development of a fetus demands balanced nutrition of a future mother. The developing fetus needs various nutrients, including proteins, fats, carbohydrates, vitamins, and mineral substances, so the organism of a pregnant woman needs to consume more elements. According to Fall (2009), the process of childbirth is determined by many factors and maternity weight is among the most important. Nutrition of a pregnant woman is the main factor that ensures the optimum development and health of a child for the subsequent periods of life (Fall, 2009, p. 594). Nutritional schedules of pregnant women should be compiled by taking into consideration all the above-mentioned factors. Therefore, both the nutrition and the weight of pregnant women should be monitored and if necessary corrected by doctors.

Gaining too much or too little weight during pregnancy can lead to irreversible results such as difficulties with controlling appetite and power consumption that manage the energy balance and metabolism of a child. In fact, it can influence the subsequent growth and weight of a child in a long-term perspective (SACN, 2011, p. 30). The rise of weight during pregnancy can result in the increased risk of gestational diabetes of a mother and the possibility of such child disorders as, for example, obesity (Galjaard et al., 2013, p. 1417). The Scientific Advisory Committee on Nutrition (2011) states that the

Obese women are at significantly increased risk of gestational hypertension, preeclampsia and gestational diabetes. Gestational diabetes can develop in the second half of pregnancy and if not controlled leads to excessive transfer of glucose from mother to fetus, inducing fetal hyperglycemia (SACN, 2011, p. 38).

Underweight during pregnancy can lead to such complications as premature birth and small weight of children. The UNICEF (2008) states that pregnant women with a low level of living need the alternation of their nutrition and the implementation of special prenatal preparations as well as that they should be placed in a group of the high risk of perinatal complications development (UNICEF, 2008, p. 5). The teratology of food insufficiency and low maternity weight is a new direction of the preventive obstetrics. It offers simple and cheap methods of eliminating food deficit, which is a key to the liquidation of major congenital or pre-natal abnormalities and other health disorders. Another problem, which is the overweight of pregnant women, can be solved by means of soft weight-loss or weight-control therapy that involves the decrease of the amount of consumed fats and carbohydrates without harm to the fetus (UNICEF, 2008, p. 13). Therefore, the connection of food consumption with the development of a child represents the basis for the formation of a separate branch in the medical dietology.

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Appropriateness of the Review and the Proposal Focus

Literature review should be conducted in such a way that it corresponds to the proposed focus, namely to the discussion of the effects of maternity weight during pregnancy on the state of mother’s and  child’s health in the future. In order to concentrate on the proposed focus, literature review should be based on the academic sources, clinical researches on the impact of maternity weight on children and mothers as well as on the data from practical nursing processes.

Inclusion of Primary or Secondary Sources

Both primary and secondary sources are used in this research. The primary data includes new scientific and special knowledge, while the secondary sources represent the results of the analytical and logical processing of the primary sources. Secondary sources are beneficial as they often allow better understanding of the reports that contain the primary data. The combination of the primary and secondary data allows market researchers to increase the quality of work. A correct analysis of the secondary data allows giving full answers to the research question.

Methodology

Study Type

Research represents a mixed study, which uses both qualitative and quantitative research types in order to understand the impact of maternity weight on the state of health of a mother and a child. Both research types are used for the better accuracy of the obtained data, because in the quantitative research the accuracy of the results depends on the validity and reliability of the measurement instruments, while in the qualitative research the reliability of the obtained data substantially depends on the researcher. The given paper uses qualitative methods  for the primary study of the research question. Later, the key aspects are characterized quantitively.

Study Design

The given research represents an observational study, so that the information for it is collected without the attempts to change the research participants or agents.

Rationale for the Use of the Selected Study Design

The observational study was chosen for the given research as it allows answering questions “Who? Where? When?’’. The research represents the observation of the series of cases of 10-100 people. This study design gives a general idea of the impact of the maternity weight on the health of a child and a mother in the population of pregnant women between 20-35 years old without comparison with the other groups.

Sample Size and Type

The sample size is a necessary condition for the possible generalization of the research findings. It should be representative in order to reflect characteristics that are important for the whole population. The unit sample represents the element of the generalization based on the outputs received in the case of its study. It is necessary to reveal the minimum sample size, which is able to provide the possibility of the further generalization of the findings. The sample size is composed of 25 pregnant women, whose weight will be monitored during their pregnancy. This size will allow generalizing the data received in the observational study.  

Sampling Method and Inclusion/Exclusion Criteria

There are several methods of the inclusion of unit samples. They are divided into non-random (non-probability sampling) and casual (probability sampling) methods. The non-random methods include the participation of the third parties in the sampling as well the application of spontaneous, directed, and snowball methods. The non-random methods are cheap and do not require much time. However, the use of these methods considerably limits the further generalization of the findings. Therefore, a simple random sampling method, which provides all members of the general set of pregnant women with equal chances to be included into the sampling, is used for the objective sampling in the conducted research.

Data Collection Method and Process

Due to the fact that sampling in mixed researches is not big, the collection of data in the given research is performed by the application of individualized methods (observation, semi-structures interviews, focus group). Moreover, the results of the data interpretation include words rather than digital values (detection of the theories that explain the behavior of people). The successful collection and interpretation of data depends on the skills of a researcher, who at the same time is an active part of the process of data gathering and analysis.

Method for Protection of Human Subject (consent)

Patients can participate in the scientific research only after they obtain the full information on it and give informed and voluntary consent to participate. The informed consent is one of the most important elements of the ethical aspect of medical experiments. After giving agreement for participation in the research on the impact of the maternity weight on the health condition of a woman and a child in the future, pregnant women become acquainted with all aspects of the research. The informed consent is documented by signing a special form.

The participants of a given research should be informed about purposes and methods of the research as well as familiarized with the course of treatment; the available alternative courses of treatment; potential advantages and risks; possible complications and inconveniences of the participation in the research. Basing on the obtained information, pregnant women should give the voluntary consent to participate in the research. This consent cannot be received by force. Moreover, a participant has the right to leave the research, and it will not exert any impact on further provision of medical care to this patient. The questionnaire and the consent form are presented in the Appendix 1 and Appendix 2.

Data Analysis

Data Analysis Method

The analysis and processing of the obtained information will reveal the connection of the researched variables. The primary data analysis methods include the processing of data received during the empirical research, including the answers of respondents, assessment of experts, and observations. The methods of grouping, tabulation, calculation of the multivariate distribution of signs, and classification are used in the given research. The secondary data analysis methods include the graphical representation of data through tables and diagrams. Statistical analysis plays a key role in the evaluation of the research findings. Statistical regularities and dependences allow the researcher to make certain generalizations and conclusions on the researched subject. The data analysis method as well as the method for displaying findings is clearly described.

Applicability in the Nursing Practice

Significance for Nursing

The problem of maternity weight and its impact on the future development of a child and a mother is important for the nursing practice. Moreover, the given research has proved the need of applying an individual approach to each pregnant woman’s nutrition, depending on her body weight, and the need to follow the recommended nutrition plan. Significant risk factors connected to the dietng plan of a mother are defined in the given study. The research of this impact allows developing the number of methods and recommendations aimed at controlling nutritional control and monitoring maternity weight during pregnancy.

Contribution to the Nursing Knowledge

The given research has greatly contributed to the development of the nursing knowledge as it has revealed the tendencies of the maternity weight impact on the development of a child and a mother. This knowledge allows developing the following recommendations for pregnant women:

• All pregnant women need a thorough analysis of their eating habits. They also should control maternity weight, including the body mass index, the family habits of nutrition, and vitamin content;
• Irrespective of the maternity weight during pregnancy, it is necessary to control the body weight in order to prevent possible post-natal consequences.

The proposal of the given research is complete and it can be used by the other researchers in order to conduct a profound and well-developed empirical analysis. The study can contribute to the development of such nursing areas as maternal-child nursing, nurse midwifery, neonatal nursing, obstetrics, pediatric nursing, etc.