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Effect of Pregnancy Weight Monitoring on Excessive Gestational Weight Gain Detection among Pregnant Women in Nigeria

Abstract

Excessive gestational weight gain is an important maternal health concern because weight gain above recommended ranges during pregnancy may be associated with adverse maternal and fetal outcomes, including gestational diabetes, hypertensive disorders of pregnancy, caesarean delivery, excessive fetal growth, postpartum weight retention, and increased long-term risk of obesity. Regular monitoring of maternal weight during pregnancy provides an opportunity to identify abnormal patterns of weight gain and facilitate timely nutritional counselling, physical activity guidance, clinical assessment, and appropriate follow-up. However, inconsistent weight monitoring, inadequate antenatal attendance, limited access to functional weighing equipment, poor documentation, inadequate counselling, and limited awareness of recommended gestational weight gain may hinder early identification of excessive weight gain among pregnant women in Nigeria. Against this background, this study investigates the effect of pregnancy weight monitoring on excessive gestational weight gain detection among pregnant women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Andersen's Behavioral Model of Health Services Use. The Health Belief Model explains how pregnant women's perceptions of the risks associated with excessive gestational weight gain, perceived benefits of weight monitoring, perceived barriers, and cues to action may influence participation in monitoring services. Social Cognitive Theory emphasizes self-monitoring, behavioural reinforcement, social support, environmental influences, and self-efficacy in maintaining healthy pregnancy-related weight behaviours. Andersen's Behavioral Model explains how predisposing characteristics, enabling resources, and perceived healthcare needs influence utilization of antenatal weight-monitoring services. Collectively, these theoretical perspectives provide a suitable framework for explaining how pregnancy weight monitoring may influence the detection of excessive gestational weight gain among pregnant women in Nigeria. The study will adopt a quantitative quasi-experimental, retrospective cohort, or analytical cross-sectional research design, depending on the availability of antenatal and weight-monitoring records. The study population will comprise pregnant women attending selected antenatal clinics, primary healthcare centres, hospitals, maternity facilities, and maternal health programmes across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible pregnant women. Pregnancy weight monitoring will be assessed using indicators such as frequency of weight measurement, availability and functionality of weighing equipment, timing of measurements, documentation of maternal weight, calculation or monitoring of gestational weight gain, availability of trained healthcare personnel, nutritional counselling, physical activity guidance, individualized weight-management advice, and referral for further assessment where necessary. Excessive gestational weight gain detection will be assessed using indicators such as identification of weight gain above recommended pregnancy-specific ranges, abnormal weight-gain patterns, gestational age at detection, classification of excessive weight gain, referral for nutritional or clinical assessment, and documented follow-up. Where appropriate, pre-pregnancy or early-pregnancy weight, height, body mass index, gestational age, and serial pregnancy weights will be used to assess gestational weight gain according to relevant clinical recommendations. Data will be collected using structured questionnaires, antenatal records, maternal health records, weight-monitoring charts, clinic registers, nutritional counselling records, and relevant healthcare documents. Descriptive statistics will be used to summarize participants' characteristics, weight-monitoring patterns, gestational weight gain, and detection rates. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of pregnancy weight monitoring on excessive gestational weight gain detection. Where a quasi-experimental design is adopted, detection rates before and after implementation of structured weight-monitoring services may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that pregnancy weight monitoring has a significant positive effect on the detection of excessive gestational weight gain among pregnant women in Nigeria. Women who receive regular and properly documented weight monitoring are expected to have a higher likelihood of excessive gestational weight gain being identified early than women without consistent monitoring. Early detection may create opportunities for individualized nutritional counselling, physical activity guidance, assessment of related pregnancy risks, and closer maternal and fetal monitoring. Regular monitoring may also increase women's awareness of healthy pregnancy weight gain and encourage them to adopt appropriate dietary and lifestyle practices. However, inadequate antenatal attendance, limited availability of functional weighing equipment, poor documentation, insufficient healthcare-provider training, financial barriers, and limited access to qualified nutrition professionals may reduce the effectiveness of weight-monitoring services. The study therefore expects routine, accurate, accessible, and well-integrated pregnancy weight monitoring to contribute significantly to improved detection and management of excessive gestational weight gain among pregnant women in Nigeria. The study is expected to contribute to the literature on pregnancy weight monitoring, excessive gestational weight gain, maternal nutrition, antenatal care, pregnancy weight management, maternal health, nutritional counselling, obesity prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, obstetricians, nurses, midwives, nutritionists, community health workers, maternal health organizations, development partners, and policymakers regarding strategies for improving maternal weight monitoring. The study will also provide evidence-based recommendations for strengthening routine maternal weight assessment during antenatal care, improving documentation and interpretation of gestational weight gain, training healthcare providers, integrating nutritional counselling into antenatal services, improving access to functional weighing equipment, and establishing appropriate referral and follow-up systems for pregnant women with excessive gestational weight gain across Nigeria.

Keywords: Pregnancy weight monitoring, excessive gestational weight gain, pregnant women, maternal weight, antenatal care, maternal nutrition, weight management, nutritional counselling, pregnancy monitoring, obesity prevention, Nigeria, public health.