Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.
Eating Disorders Program at Homewood Health Centre, Guelph, Ontario, Canada.
BMC Pregnancy Childbirth. 2021 Jan 21;21(1):70. doi: 10.1186/s12884-021-03555-5.
Previous studies have noted traditional physical, demographic, and obstetrical predictors of inadequate or excess gestational weight gain, but the roles of psychological and behavioral factors are not well established. Few interventions targeting traditional factors of gestational weight gain have been successful, necessitating exploration of new domains. The objective of this study was to identify novel psychological and behavioral factors, along with physical, demographic, and obstetrical factors, associated with gestational weight gain that is discordant with the 2009 Institute of Medicine guidelines (inadequate or excess gain).
We recruited English-speaking women with a live singleton fetus at 8 to 20 weeks of gestation who received antenatal care from 12 obstetrical, family medicine, and midwifery clinics. A questionnaire was used to collect information related to demographic, physical, obstetrical, psychological, and behavioural factors anticipated to be related to weight gain. The association between these factors and total gestational weight gain, classified as inadequate, appropriate, and excess, was examined using stepwise multinomial logistic regression.
Our study population comprised 970 women whose baseline data were obtained at a mean of 14.8 weeks of gestation ±3.4 weeks (standard deviation). Inadequate gestational weight gain was associated with obesity, planned gestational weight gain (below the guidelines or not reported), anxiety, and eating sensibly when with others but overeating when alone, while protective factors were frequent pregnancy-related food cravings and preferring an overweight or obese body size image. Excess gestational weight gain was associated with pre-pregnancy overweight or obese body mass index, planned gestational weight gain (above guidelines), frequent eating in front of a screen, and eating sensibly when with others but overeating when alone, while a protective factor was being underweight pre-pregnancy.
In addition to commonly studied predictors, this study identified psychological and behavioral factors associated with inadequate or excess gestational weight gain. Factors common to both inadequate and excessive gestational weight gain were also identified, emphasizing the multidimensional nature of the contributors to guideline-discordant weight gain.
既往研究已经注意到传统的体格、人口统计学和产科预测因素与不足或过多的妊娠期体重增加有关，但心理和行为因素的作用尚未明确。针对妊娠期体重增加的传统因素的干预措施收效甚微，因此需要探索新的领域。本研究旨在确定与 2009 年美国医学研究所指南（不足或过多增加）不一致的妊娠期体重增加相关的新的心理和行为因素，以及体格、人口统计学和产科因素。
我们招募了在妊娠 8 至 20 周期间接受 12 个产科、家庭医学和助产士诊所产前保健的英语为母语的单胎活产妇女。使用问卷收集与预期与体重增加相关的人口统计学、体格、产科、心理和行为因素的信息。使用逐步多变量逻辑回归检查这些因素与总妊娠期体重增加（不足、适当和过多）之间的关联。
我们的研究人群包括 970 名妇女，其基线数据在妊娠 14.8 周±3.4 周（标准差）时获得。妊娠期体重增加不足与肥胖、计划的妊娠期体重增加（低于指南或未报告）、焦虑以及与他人一起时饮食合理但独自时暴饮暴食有关，而保护因素是频繁的妊娠相关食物渴望和偏爱超重或肥胖体型。妊娠期体重增加过多与妊娠前超重或肥胖的体重指数、计划的妊娠期体重增加（高于指南）、经常在屏幕前进食以及与他人一起时饮食合理但独自时暴饮暴食有关，而保护因素是妊娠前体重不足。
除了常见的预测因素外，本研究还确定了与不足或过多妊娠期体重增加相关的心理和行为因素。还确定了与不足和过多妊娠期体重增加都相关的因素，强调了与指南不符的体重增加的多种贡献因素。
