School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125, Australia.
Midwifery. 2013 Feb;29(2):110-4. doi: 10.1016/j.midw.2011.12.001. Epub 2012 Nov 15.
nearly half of all women exceed the guideline recommended pregnancy weight gain for their Body Mass Index (BMI) category. Excessive gestational weight gain (GWG) is correlated positively with postpartum weight retention and is a predictor of long-term, higher BMI in mothers and their children. Psychosocial factors are generally not targeted in GWG behaviour change interventions, however, multifactorial, conceptual models that include these factors, may be useful in determining the pathways that contribute to excessive GWG. We propose a conceptual model, underpinned by health behaviour change theory, which outlines the psychosocial determinants of GWG, including the role of motivation and self-efficacy towards healthy behaviours. This model is based on a review of the existing literature in this area.
there is increasing evidence to show that psychosocial factors, such as increased depressive symptoms, anxiety, lower self-esteem and body image dissatisfaction, are associated with excessive GWG. What is less known is how these factors might lead to excessive GWG. Our conceptual model proposes a pathway of factors that affect GWG, and may be useful for understanding the mechanisms by which interventions impact on weight management during pregnancy. This involves tracking the relationships among maternal psychosocial factors, including body image concerns, motivation to adopt healthy lifestyle behaviours, confidence in adopting healthy lifestyle behaviours for the purposes of weight management, and actual behaviour changes.
health-care providers may improve weight gain outcomes in pregnancy if they assess and address psychosocial factors in pregnancy.
近一半的女性体重增长超过了其身体质量指数（BMI）类别所推荐的孕期增重指南。过度妊娠体重增加（GWG）与产后体重滞留呈正相关，是母亲及其子女长期、更高 BMI 的预测因素。一般来说，社会心理因素在 GWG 行为改变干预中并未被针对，然而，包含这些因素的多因素、概念性模型可能有助于确定导致过度 GWG 的途径。我们提出了一个概念模型，该模型以健康行为改变理论为基础，概述了 GWG 的社会心理决定因素，包括对健康行为的动机和自我效能感的作用。该模型基于该领域现有文献的综述。
越来越多的证据表明，社会心理因素，如抑郁症状增加、焦虑、自尊心降低和身体形象不满，与过度 GWG 相关。不太清楚的是这些因素如何导致过度 GWG。我们的概念模型提出了一个影响 GWG 的因素途径，这可能有助于理解干预措施如何影响孕期体重管理的机制。这涉及到跟踪产妇社会心理因素之间的关系，包括对身体形象的关注、对采用健康生活方式行为的动机、对为体重管理而采用健康生活方式行为的信心，以及实际行为的改变。
如果医疗保健提供者在孕期评估和解决社会心理因素，他们可能会改善孕期的增重结果。
