Psychosocial correlates of health-promoting and health-impairing behaviors in pregnancy

Abstract

Behaviors during pregnancy including eating, exercise, cigarette smoking, and other substance use affect the health of a pregnant woman and her fetus. However, little is known about what influences pregnant women to engage in these health behaviors. Based upon relevant theory, we hypothesized that because health-promoting behaviors require continuous efforts that may depend upon a reliable, stable set of resources, intrapersonal traits, namely self-esteem and optimism, would be associated with the practice of health-promoting behaviors during pregnancy. In addition, we hypothesized that variables reactive to the more immediate context, pregnancy-specific stress and perceived control over pregnancy, would be associated with the practice of health-impairing behaviors. We distinguished health-promoting and health-impairing behaviors in a diverse sample of 165 pregnant women and investigated whether such behaviors are associated with distinct psychosocial factors. Results supported study hypotheses and provide evidence that even after controlling for maternal age, income, body mass index, and gestation, a stable, self-relevant disposition, self-esteem, is associated with the practice of health-promoting behaviors in pregnancy whereas pregnancy-specific stress, a situationally-evoked factor, is associated with the practice of health-impairing prenatal behaviors. Perceived control over pregnancy, which may reflect stable disposition and situational perceptions, was associated with health-promoting and health-impairing behaviors.

• Health behaviors
• perceived control
• pregnancy
• self-esteem
• stress

Current knowledge on this subject

• Health behaviors during pregnancy influence the health of a pregnant woman and her fetus.

• Little is known about what influences women to engage in health behaviors during pregnancy.

• What motivates people to engage in health-promoting behaviors may differ from what motivates them to refrain from health-impairing behaviors.

What this study adds

• Results support the value of distinguishing health-promoting and health-impairing behaviors in pregnancy.

• A stable, self-relevant disposition, self-esteem, is associated with the practice of health-promoting behaviors during pregnancy whereas stress, a situationally-evoked factor, is associated with the practice of health-impairing behaviors during pregnancy.

• Perceived control over pregnancy, which may reflect stable disposition as well as situational perceptions, is associated with both health-promoting and health-impairing behaviors in pregnancy.

Acknowledgements

The authors are grateful to Dr. Alan Monheit, the staff of the prenatal facility, and the women who participated in this project.