Abstract
Background
Excess gestational weight gain (GWG) contributes to long-term obesity in mothers and
children. To guide the tailoring of interventions to prevent excess GWG, a better
understanding is needed of the lifestyle-related health cognitions that influence
women’s attempts to manage GWG.
Objective
To examine the relationship between health cognitions and excess GWG for women who
enter pregnancy at a healthy weight (body mass index <25) or overweight (body mass
index ≥25). It was hypothesized that health cognitions with a positive (negative)
influence on health behavior would be associated with lower (higher) likelihood of
excess GWG and that specific associations would differ between weight status groups.
Design
This prospective, observational study commenced when participants were <20 weeks’
gestation, continuing until the end of their pregnancy. A self-administered quantitative
survey at recruitment assessed prepregnancy weight and lifestyle-related health cognitions.
Height was measured at 16 weeks and weight at 36 weeks using standard procedures.
Participants and setting
A consecutive sample of pregnant women (n=715) were recruited from an Australian metropolitan
hospital between August 2010 and January 2011. All women <20 weeks’ gestation were
eligible unless they had preexisting type 1 or 2 diabetes or insufficient English
language skills to complete questionnaires.
Main outcome measures
Excess GWG defined according to Institute of Medicine 2009 recommendations and predisposing,
reinforcing, and enabling cognitions for lifestyle health behaviors.
Statistical analyses performed
Logistic regression analyses examined associations between health cognitions and excess
GWG stratified for prepregnancy weight status.
Results
For healthy-weight women, higher weight locus of control scores were protective against
excess GWG (odds ratio 0.6, 95% CI 0.4 to 0.8), whereas higher perceived risk scores
(personal risk and risk arising from prepregnancy weight) (odds ratio 1.3, 95% CI
1.1 to 1.7) were associated with excess GWG. For overweight women higher negative
outcome expectation scores were associated with an increased risk of excess GWG (odds
ratio 1.4, 95% CI 1.1 to 2.0).
Conclusions
Lifestyle-related health cognitions are associated with excess GWG and differed by
prepregnancy weight status, suggesting the need to tailor behavior change interventions
accordingly.
Keywords
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Biography
S. J. de Jersey is an advanced accredited practicing dietitian, Department of Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia, and a visiting research fellow, School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Biography
K. M. Mallan is a visiting research fellow, School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia, and a lecturer, School of Psychology (Brisbane Campus), Australian Catholic University, Banyo, Queensland, Australia.
Biography
L. K. Callaway is a professor of medicine, University of Queensland, Herston, Queensland, Australia, and an obstetric physician, Department of Internal Medicine, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia.
Biography
L. A. Daniels is head of the school, a professor, and a fellow of the Dietitians Association of Australia, School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Biography
J. M. Nicholson is the inaugural Roberta Holmes Professor, Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia, and with the Centre for Learning Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Article info
Publication history
Published online: February 09, 2017
Accepted:
December 14,
2016
Received:
January 31,
2016
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT Project funding was provided by the Royal Brisbane and Women’s Hospital (RBWH) Foundation for the New Beginnings Healthy Mothers and Babies Study; the RBWH Research Advisory Committee and National Health and Medical Research Council provided PhD scholarship funding (Susan de Jersey; 1017169); and Jan M. Nicholson is the Roberta Holmes Chair for the Transition to Contemporary Parenthood Program, which is funded through the Australian Communities Foundation (a Coronella subfund).
Identification
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© 2017 by the Academy of Nutrition and Dietetics.
