Weight and behavioral and psychosocial factors among ethnically diverse, low-income women after childbirth: II. Trends and correlates.
OBJECTIVE
This paper presents a longitudinal analysis of behavioral and psychosocial correlates of weight trends during the first postpartum year. Data are derived from the Austin New Mothers Study (ANMS), a longitudinal study of a low-income, tri-ethnic sample of postpartum women that incorporated serial assessment of weight and behavioral and psychosocial variables.


METHODS
Postpartum body mass index (BMI) was measured prospectively (post-delivery, 6 weeks, and 3, 6, and 12 months postpartum). The analytic sample consisted of 382 White, African American, and Hispanic women receiving maternity care funded by Medicaid who had at least three measured postpartum weights. Behavioral and psychosocial variables included energy intakes, fat intakes, physical activity, health related lifestyle, smoking, breastfeeding, contraception, depressive symptoms, emotional eating, body image, and weight-related distress.


RESULTS
Using hierarchical linear modeling to incorporate baseline only and time-varying effects, significant associations with postpartum BMI were found for the following variables: ethnicity (p = .001), time of weight measurement (p < .001), the interaction of ethnicity and time (p = .005), pre-pregnant BMI (p < .001), gestational weight gain (p < .001), weight-related distress (p < .001), and energy intakes (p = .005). After adjusting for covariates, ethnic groups displayed differing trends in postpartum BMI resulting in White women having significantly lower BMIs at 12 months postpartum compared to ethnic minority women (p's < .01).


CONCLUSIONS
Behavioral and psychosocial variables contribute to a fuller understanding of BMI status of low-income women during the first postpartum year.
Walker
Lorraine
L
University of Texas at Austin, School of Nursing, 1700 River Street, Austin, TX 78701-1499, USA. lwalker-admin@mail.nur.utexas.edu
Freeland-Graves
Jeanne H
JH
Milani
Tracey
T
George
Goldy
G
Hanss-Nuss
Henry
H
Kim
Minseong
M
Sterling
Bobbie Sue
BS
Timmerman
Gayle M
GM
Wilkinson
Susan
S
Arheart
Kristopher L
KL
Stuifbergen
Alexa
A
D000328:Adult; D001741:Black or African American / Q000523:psychology; D015992:Body Mass Index; D001835:Body Weight / Q000208:ethnology; D003466:Cultural Characteristics; D019052:Depression, Postpartum / Q000208:ethnology* / Q000523:psychology; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D007231:Infant, Newborn; D008019:Life Style / Q000208:ethnology; D016014:Linear Models; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology; D049590:Postpartum Period / Q000208:ethnology* / Q000523:psychology; D011203:Poverty / Q000208:ethnology* / Q000706:statistics & numerical data; D011247:Pregnancy; D011446:Prospective Studies; D012907:Smoking / Q000208:ethnology; D012923:Social Class; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D015430:Weight Gain / Q000208:ethnology*; D044465:White People / Q000523:psychology