Impact of race and locus of control on gestational weight gain

Excess gestational weight gain is associated with increased maternal and child morbidity. Few studies have examined how the interplay of psychosocial factors and race affect gestational weight gain. We analyzed survey responses of 98 low-income postpartum women 2-6 weeks post delivery, from July 1-December 31, 2008. Subjects were clients of the Maternity Care Coalition (MCC), a Philadelphia community-based pregnancy outreach and advocacy agency. Excess weight gain was weight above Institute of Medicine recommendations based on pre-pregnancy body mass index (BMI).

Mean (SD) age of women was 24.6(5.7) years, with 7% white, 66% black, 22% Hispanic. 35% of women had normal pre-pregnant BMI, 32% overweight, and 26% obese. Black women had higher rates of overweight compared to Hispanic women (42% vs. 15%, p=0.05), but there was no difference in rates of obesity between the two groups. 23% women were classified as achieving adequate weight gain based on their pre-pregnant BMI, and 49% were classified as gaining excessive weight. Mean gestational weight gain among black women was higher than Hispanic women (36.2 lbs. vs. 28 lbs, p<0.001), but rates of classification of women into the excessive weight gain category were no different among black and Hispanic women (46% vs. 43%, p=0.83). In multivariate analysis, there was a significant association of reported feeling of control over pregnancy weight gain with gestational weight gain (beta -12 pounds, p=0.025). Pre-pregnant obesity was also associated with decreased gestational weight gain (beta -13 pounds, p=0.03); age, race, and ethnicity did not have significant association.