title: Relationship of psychosocial status to low prenatal weight gain among nonobese black and white women delivering at term.
abstract: OBJECTIVE
  To examine the association of six indices of psychosocial well-being with low prenatal weight gain.
  
  
  METHODS
  Scales assessing depression, trait anxiety, stress, mastery, self-esteem, and social support were self-administered at mid-pregnancy to 536 black and 270 white low-income, nonobese, multiparous women who subsequently delivered at term. All women had one or more risk factors for fetal growth restriction. The association of individual scale scores with prenatal weight gain values below current Institute of Medicine guidelines was examined while controlling for sociodemographic and reproductive variables, and for time between last weight observation and delivery.
  
  
  RESULTS
  None of the scales were associated with low gain among black women. Among white women, poor scores (worst quartile) on four of the scales were associated with increased adjusted odds ratios for low gain, including 2.5 for high trait anxiety, 3.0 for increased levels of depression, 3.9 for low mastery, and 7.2 for low self-esteem. When scale scores and weight gain were examined as continuous variables, poor scores on five of the six scales were associated with lower weight gain values among white women (scores on the stress scale were the exception).
  
  
  CONCLUSIONS
  These data suggest an important role for psychosocial factors in the etiology of low prenatal weight gain among white women but show no such role for black women. Along with reports of wide inter-individual variability in the energy costs of pregnancy, these data also suggest that attempts to manipulate pregnancy weight gain through dietary means will meet with variable success until psychosocial and other factors affecting prenatal energy intake and/or utilization are further delineated.
authors.affiliation: Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Hickey
authors.forename: S P
authors.initials: SP
authors.lastname: Cliver
authors.forename: R L
authors.initials: RL
authors.lastname: Goldenberg
authors.forename: S F
authors.initials: SF
authors.lastname: McNeal
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D001741:Black or African American; D036861:Delivery, Obstetric; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D010298:Parity; D011203:Poverty; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000208:ethnology* / Q000502:physiology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012944:Social Support; D015430:Weight Gain / Q000502:physiology*; D044465:White People