title: Psychosocial influences on weight gain attitudes and behaviors during pregnancy.
abstract: OBJECTIVE
  To examine pregnant women's weight-related attitudes and behaviors in relation to a constellation of psychosocial characteristics, prepregnancy body habitus, and gestational weight gain.
  
  
  METHODS
  One hundred-thirty women with low-risk, normal pregnancies.
  
  
  METHODS
  Cross-sectional, observational study assessed attitudes about weight gain at 36 weeks' gestation. Psychosocial characteristics, including anxiety, depression, social support, emotionality, and pregnancy-specific and nonspecific stress appraisal were assessed between 28 and 36 weeks' gestation.
  
  
  METHODS
  Principal components factor analysis, Pearson correlations, t tests, and analysis of variance.
  
  
  RESULTS
  A range of positive and negative attitudes about weight gain was expressed. Twenty-one percent (n=27) of the sample endorsed at least one weight-restrictive behavior during pregnancy. Women who reported more weight-restrictive behaviors were more anxious (r=.24, P<.01), depressed (r=.29,P<.001), angry (r=.29, P<.001), stressed (r=.23, P<.01), and felt less uplifted (r=-.21, P<.05) about their pregnancies in general. Higher Positive Pregnancy Body Image scores were associated with feeling better about the pregnancy in general (r=.35, P<.001), fewer depressive symptoms, and less anger (both r=.20, both P<.01). Women who were self conscious about their weight gain felt more hassled by their pregnancies (r=.21, P<.05), greater anger (r=.21, P<.05), and more support from partners (r=.22, P<.05). Prepregnancy body mass index was unrelated, but negative attitudes about weight gain existed even among women who gained within recommended ranges.
  
  
  CONCLUSIONS
  Women's attitudes about weight gain in pregnancy are imbedded in their orientation toward pregnancy as well as their general psychological functioning. Effective nutrition counseling for pregnant women should include consideration of weight-restrictive behaviors, the degree to which the pregnancy is perceived as positive and uplifting, and whether weight gain attitudes may be associated with their relationship with a spouse or partner.
authors.affiliation: Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. jdipietro@jhsph.edu
authors.forename: Janet A
authors.initials: JA
authors.lastname: Dipietro
authors.forename: Sarah
authors.initials: S
authors.lastname: Millet
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Costigan
authors.forename: Edith
authors.initials: E
authors.lastname: Gurewitsch
authors.forename: Laura E
authors.initials: LE
authors.lastname: Caulfield
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D001290:Attitude; D001294:Attitude to Health; D001828:Body Image; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008425:Maternal Behavior / Q000502:physiology / Q000523:psychology*; D011247:Pregnancy / Q000502:physiology / Q000523:psychology*; D012944:Social Support; D015430:Weight Gain / Q000502:physiology