title: What psychological, physical, lifestyle, and knowledge factors are associated with excess or inadequate weight gain during pregnancy? A cross-sectional survey.
abstract: OBJECTIVE
  Excess weight gain during pregnancy is associated with increased risks of overweight and obesity in both women and their children. Conversely, inadequate weight gain can predispose to growth restriction, which is also associated with childhood obesity. Because most pregnant women now gain more weight than is recommended in guidelines and a substantial portion gain less than the recommended amounts, we sought to determine factors associated with inappropriate weight gain, including physical, lifestyle, knowledge, and particularly psychological factors.
  
  
  METHODS
  We conducted a self-administered cross-sectional survey of English-speaking women with a live, singleton gestation. Biologically relevant variables significant at P < 0.10 were included in multiple logistic regression.
  
  
  RESULTS
  Three hundred thirty women completed the survey, a response rate of 90.7%. Gaining weight above the amount recommended in guidelines was associated with planning to do so (adjusted OR [aOR] 11.18; 95% CI 4.45 to 28.06), bedtime television (aOR 2.38; 95% CI 1.08 to 5.23), and higher emotional instability scores (aOR 1.26; 95% CI 1.10 to 1.44). Inadequate weight gain was associated with less satisfaction with body weight (aOR 4.84; 95% CI 1.56 to 15.02) and bedtime television (aOR 3.92; 95% CI 1.50 to 10.30), while self-efficacy towards healthy weight was protective (aOR 0.91; 95% CI 0.83 to 0.99).
  
  
  CONCLUSIONS
  Planned weight gain was most strongly associated with excess gestational weight gain, followed by bedtime television watching and emotional instability, while inadequate gain was associated with less satisfaction with body weight and bedtime television watching. Better characterization of psychological and other factors that predict inappropriate gain will be critical for providing a basis for interventions.
authors.affiliation: Departments of Obstetrics and Gynecology (Division of Maternal-Fetal Medicine) and Radiology, McMaster University, Hamilton ON; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton ON.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: McDonald
authors.affiliation: Faculty of Health Sciences, McMaster University, Hamilton ON.
authors.forename: Christina K
authors.initials: CK
authors.lastname: Park
authors.affiliation: School of Nursing, Western University, London ON.
authors.forename: Valerie
authors.initials: V
authors.lastname: Timm
authors.affiliation: Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton ON.
authors.forename: Louis
authors.initials: L
authors.lastname: Schmidt
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton ON.
authors.forename: Binod
authors.initials: B
authors.lastname: Neupane
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton ON.
authors.forename: Joseph
authors.initials: J
authors.lastname: Beyene
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008019:Life Style; D011247:Pregnancy / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013690:Television; D015430:Weight Gain; D055815:Young Adult
keywords: gestational weight gain; lifestyle factors; planned gain; psychological factors; survey