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探究孕期身体不满意及其与孕期体重增加、肥胖和体重歧视之间的关联。

Exploring body dissatisfaction in pregnancy and the association with gestational weight gain, obesity, and weight stigma.

作者信息

Hill Isabelle F, Angrish Kirina, Nutter Sarah, Ramos-Salas Ximena, Minhas Harneet, Nagpal Taniya S

机构信息

Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, ON, Canada.

Department of Educational Psychology and Leadership Studies, University of Victoria, BC, Canada.

出版信息

Midwifery. 2023 Apr;119:103627. doi: 10.1016/j.midw.2023.103627. Epub 2023 Feb 13.

Abstract

OBJECTIVE

Body dissatisfaction in pregnancy has been associated with negative psychological maternal outcomes, including increased risk of postpartum depression. This study aimed to explore weight-related factors that influence body dissatisfaction in pregnancy, including gestational weight gain (GWG), weight stigma, obesity, and weight loss attempts before pregnancy.

DESIGN

Secondary analysis of a larger cross-sectional study.

SETTING

Online survey administered via Qualtrics.

PARTICIPANTS

≥12 weeks pregnant, ≥18 years of age, having a singleton pregnancy and residing in Canada.

MEASUREMENTS AND FINDINGS

A battery of questionnaires were completed, including the Body Image in Pregnancy Scale (BIPS) sub-scale. The BIPS scores were compared based on experiences of weight stigma in pregnancy, perception towards their GWG, weight loss attempts before pregnancy, obesity, and GWG category classified as excessive or not referring to Institute of Medicine (2009) guidelines. Significant differences were entered into a linear regression model with BIPS scores as the dependent variable. Significance was accepted as p<0.05. A total of 182 participants completed the survey. There were no differences in BIPS scores based on GWG category (p = 0.160), or obesity (p = 0.230). Poorer BIPS scores were reported by those who felt they had gained 'too much' pregnancy weight than 'appropriate' (p<0.001), and among those who were trying to lose weight before pregnancy compared to those who were not (p = 0.002). Poorer BIPS scores were also reported by individuals who indicated they had experienced weight stigma during pregnancy compared to those who had not (p<0.001). Regression results showed that significant variables were perceptions towards GWG (p = 0.003) and experiencing weight stigma in pregnancy (p = 0.011).

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Perceptions towards GWG and experiencing weight stigma can influence body dissatisfaction in pregnancy. Given the detrimental physical and psychological consequences of body dissatisfaction, effective strategies to reduce prenatal weight stigma are needed, such as training maternal healthcare providers to offer sensitive preconception and prenatal weight counselling.

摘要

目的

孕期身体不满意与不良的母亲心理结局相关,包括产后抑郁风险增加。本研究旨在探讨影响孕期身体不满意的体重相关因素,包括孕期体重增加(GWG)、体重羞辱、肥胖以及孕前的减肥尝试。

设计

对一项更大规模横断面研究的二次分析。

设置

通过Qualtrics进行的在线调查。

参与者

怀孕≥12周、年龄≥18岁、单胎妊娠且居住在加拿大。

测量与结果

完成了一系列问卷,包括孕期身体意象量表(BIPS)子量表。根据孕期体重羞辱经历、对其GWG的认知、孕前减肥尝试、肥胖情况以及根据医学研究所(2009年)指南分类为过度或不过度的GWG类别,对BIPS得分进行比较。将显著差异纳入以BIPS得分为因变量的线性回归模型。显著性水平设定为p<0.05。共有182名参与者完成了调查。基于GWG类别(p = 0.160)或肥胖情况(p = 0.230),BIPS得分无差异。认为自己孕期体重增加“过多”而非“合适”的人,其BIPS得分较差(p<0.001),与未尝试减肥的人相比,孕前尝试减肥的人BIPS得分也较差(p = 0.002)。与未经历过体重羞辱的人相比,报告在孕期经历过体重羞辱的人BIPS得分也较差(p<0.001)。回归结果显示,显著变量为对GWG的认知(p = 0.003)和孕期经历体重羞辱(p = 0.011)。

关键结论及对实践的启示

对GWG的认知和经历体重羞辱会影响孕期身体不满意。鉴于身体不满意对身体和心理的有害后果,需要有效的策略来减少产前体重羞辱,例如培训孕产妇保健提供者提供敏感的孕前和产前体重咨询。

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