A goal set too high: factors associated with planning excess gestational weight gain in a prospective cohort study

Abstract

Objective

This study aimed to understand physical, knowledge, psychological, and lifestyle factors associated with planned excess gestational weight gain (GWG), a strong and potentially modifiable predictor of actual excess GWG, which contributes to maternal and child obesity along with other adverse maternal and fetal outcomes.

Methods

This is a secondary analysis of data from a prospective cohort study where women completed a questionnaire in early pregnancy. Women were asked to report their planned GWG, which was then categorized as above, within, or below the Institute of Medicine (IOM) guidelines. Univariable and multivariable analyses were performed to identify variables associated with planned excess GWG.

Results

Of 970 women included in the analysis, 300 reported a planned GWG above the IOM guidelines. Predictors of excess planned GWG included reporting healthcare provider recommendations to gain weight above the guidelines (adjusted odds ratio [aOR], 62.17; 95% confidence interval [CI], 13.75–281.03), overestimating first trimester weight gain recommendations (aOR, 1.83; 95% CI, 1.21–2.77), believing in risks to the baby with inadequate GWG (aOR 2.16; 95% CI,1.29–3.60), inaccurate self-perceived prepregnancy body size (aOR, 1.88; 95% CI, 1.22–2.89), low or high emotional suppression (aOR, 1.78; 95% CI, 1.06–2.99; and aOR, 2.57; 95% CI, 1.21–5.45, respectively), physical inactivity (aOR, 1.10; 95% CI, 1.03–1.17), and overweight or obesity (aOR, 5.76; 95% CI, 3.70–8.98; and aOR, 11.46; 95% CI, 6.54–20.06, respectively). Protective factors against planned excess GWG included increased maternal age (aOR, 0.95; 95% CI, 0.92–0.99), and believing in risks to themselves with inadequate GWG (aOR 0.64; 95% CI, 0.42–0.97) or believing in risks to the baby with excess GWG (aOR, 0.49; 95% CI, 0.27–0.88).

Conclusions

Women with overweight or obesity are at greater risk of prospectively planning excess GWG, and may especially benefit from healthcare provider counseling on appropriate GWG. Other modifiable factors for planned excess GWG included knowledge about risks of inappropriate weight gain and physical inactivity.

Keywords:

• Gestational weight gain
• maternal health
• patient education
• obesity
• psychosocial variables

Disclosure statement

The authors report no conflicts of interest.

Author contributions

SDM, MV, AB, WS, and LS conceptualized the study and study design. ZMY curated the data and conducted the statistical analyses. CHL was involved in data collection and drafted the initial manuscript. All authors were involved in reviewing and editing the paper, and approved the manuscript.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research under Grant # MOP-142253. SDM is supported by a Tier II Canada Research Chair Sponsor Award #950-229920. AB is supported by the Ada Slaight and Slaight Family Maternity Care Directorship. None of the funding or supporting agencies had any role in the study concept, design, analyses, interpretation of data, manuscript preparation or decision to submit the manuscript for publication.