title: Behaviours of overweight and obese women during pregnancy who achieve and exceed recommended gestational weight gain.
abstract: BACKGROUND
  Excessive gestational weight gain (GWG) is associated with increased risk of pregnancy-related complications, postpartum weight retention, and long-term obesity. Little is known about the behavioural habits of pregnant women who achieve and exceed recommended GWG.
  
  
  METHODS
  In 2011, qualitative interviews were conducted in Pennsylvania with postpartum women who were overweight or obese prior to pregnancy to ascertain their behaviours and attitudes regarding dietary habits, physical activity, and self-monitoring during pregnancy. Thematic analysis identified the habits of women who achieved and exceeded recommended GWG guidelines.
  
  
  RESULTS
  Of the 29 women interviewed, 11 had appropriate GWG and 18 had excessive GWG. Women achieving appropriate GWG reported modest increases in caloric intake if at all, with deliberate meal and snack planning, while women with excessive GWG described "eating-for-two." Nearly all women with excessive GWG reported exercising less during pregnancy (or remaining sedentary), while women with appropriate GWG largely increased or maintained pre-pregnancy physical activity levels. About half of the sample reported self-monitoring weight gain during pregnancy, but women achieving recommended GWG tied their weight monitoring with GWG goals consistent with recommended guidelines.
  
  
  CONCLUSIONS
  Women who achieved appropriate GWG reported deliberate dietary habits and physical activity planning, with appropriate GWG goals during pregnancy. Women exceeding recommended GWG described "eating-for-two," were sedentary, and either had no goals for GWG or intended to gain more weight than recommended.
authors.affiliation: Division of General Internal Medicine, Penn State College of Medicine, Hershey, PA 17033, United States; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, United States. Electronic address: cchuang@hmc.psu.edu.
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: Chuang
authors.affiliation: Penn State College of Medicine, Hershey, PA 17033, United States.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Stengel
authors.affiliation: Cornell University, Ithaca, NY 14852, United States.
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Hwang
authors.affiliation: Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, United States.
authors.forename: Diana
authors.initials: D
authors.lastname: Velott
authors.affiliation: Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, United States; Department of Obstetrics and Gynecology, Penn State University College of Medicine, Hershey, PA 17033, United States.
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Kjerulff
authors.affiliation: Division of General Internal Medicine, Penn State College of Medicine, Hershey, PA 17033, United States; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, United States.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Kraschnewski
mesh_terms: D000328:Adult; D001294:Attitude to Health; D015992:Body Mass Index; D004435:Eating / Q000523:psychology; D005247:Feeding Behavior; D005260:Female; D006040:Goals; D017408:Guidelines as Topic; D015438:Health Behavior; D006801:Humans; D009043:Motor Activity; D050177:Overweight / Q000523:psychology*; D010414:Pennsylvania; D011247:Pregnancy; D011295:Prenatal Care; D036301:Qualitative Research; D015430:Weight Gain / Q000502:physiology*
keywords: Gestational weight gain; Nutrition; Obesity; Physical activity; Pregnancy