Abstract
ObjectiveFetal exposure to an intrauterine environment affected by maternal obesity and excessive gestational weight gain increases the likelihood of infants born large for gestational age and childhood obesity. This study examined behavioural factors and lifestyle practices associated with women’s perceived attainability of meeting the 2009 Institute of Medicine (IOM) weight gain guidelines.MethodsCross-sectional data were collected from pregnant (n = 320) and postpartum (n = 1179) women who responded to the validated Canadian Electronic Maternal (EMat) health survey. Consenting women completed the survey through REDCap™ a secure, web-based data capture platform. Multiple logistic regression analyses were used to evaluate correlates associated with meeting or not meeting IOM recommendations. Odds ratios (ORs) were adjusted for relevant behavioural and sociodemographic covariates.ResultsThere were no significant differences between adjusted and unadjusted ORs for self-efficacy, barriers, and facilitators to weight gain during pregnancy. Women who reported worry regarding weight gain were significantly less likely to meet IOM guidelines (OR = 0.48, 95% CI = 0.33–0.69). Perceived controllability of behaviour was significantly associated with meeting IOM guidelines. An internal locus of control for weight gain was associated with an increased odds of meeting guidelines when women perceived to be in control of their weight gain (OR = 1.75, 95% CI = 1.29–2.37), healthy and exercised (OR = 1.91, 95% CI = 1.34–2.71), and when no barriers to healthy weight gain were perceived (OR = 1.43, 95% CI = 1.04–1.95); whereas, an external locus of control in which women viewed weight gain as beyond their control, was associated with a significantly reduced odds of achieving guidelines (OR = 0.58, 95% CI = 0.39–0.88).ConclusionsSelf-efficacy and perceived controllability of behaviour are key factors to consider when developing pregnancy-specific interventions to help women achieve guideline-concordant weight gain and ensure the downstream health of both mother and infant.
Highlights
In recent years, women of reproductive age are more likely to be overweight or obese [1,2]
An internal locus of control for weight gain was associated with an increased odds of meeting guidelines when women perceived to be in control of their weight gain (OR = 1.75, 95% CI = 1.29–2.37), healthy and exercised (OR = 1.91, 95% CI = 1.34– 2.71), and when no barriers to healthy weight gain were perceived (OR = 1.43, 95% CI = 1.04–1.95); whereas, an external locus of control in which women viewed weight gain as beyond their control, was associated with a significantly reduced odds of achieving guidelines (OR = 0.58, 95% CI = 0.39–0.88)
According to the Institute of Medicine (IOM), women with a pre-pregnancy weight categorized as underweight (BMI < 18.5 kg/m2) are recommended to gain between 12.5 to 18.0 kg; women who are categorized as normal weight (BMI 18.5 to 24.9 kg/m2) are recommended to gain between 11.5 to 16.0 kg; those categorized as overweight (BMI 25.0 to 29.9 kg/m2) are recommended to gain between 7.0 to 11.5 kg; and lastly, women who are categorized as obese are recommended to gain between 5.0 to 9.0 kg [5]
Summary
Women of reproductive age are more likely to be overweight or obese [1,2]. According to the IOM, women with a pre-pregnancy weight categorized as underweight (BMI < 18.5 kg/m2) are recommended to gain between 12.5 to 18.0 kg; women who are categorized as normal weight (BMI 18.5 to 24.9 kg/m2) are recommended to gain between 11.5 to 16.0 kg; those categorized as overweight (BMI 25.0 to 29.9 kg/m2) are recommended to gain between 7.0 to 11.5 kg; and lastly, women who are categorized as obese (all classes, BMI 30.0) are recommended to gain between 5.0 to 9.0 kg [5] These guidelines, along with those from the Society of Obstetricians and Gynaecologists of Canada (SOGC) sought to mitigate adverse health consequences to both mother and child associated with excessive gestational weight gain (GWG) [5,6]. Health risks include being born LGA, preterm delivery, downstream metabolic disorder, and overweight and obesity later in life [13]
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