Psychosocial Correlates of Gestational Weight Gain in Primiparous Women

Background: Pregnancy is often the beginning of a life-long struggle with excess weight. While the effect of lifestyle factors on gestational weight gain (GWG) comprises the bulk of the literature, the growing body of work evaluating the influence of psychosocial factors on GWG has produced mixed results. Methods: We conducted a prospective analysis of 3000 first time mothers aged 18 to 35 in Pennsylvania, who were interviewed between 2009 and early 2011 after 34 weeks gestation and one month after delivery. We evaluated the relationship between psychosocial factors: pregnancy intendedness, perceived stress, depression, social support and partner relationship quality and GWG. Results: The average GWG was 34.5±15.1lbs and one third of the women achieved Institute of Medicine (IOM) recommended weight gain, while 50.2% exceeded and 16.8% gained less. Approximately 67% of the participants reported that the pregnancy was intended and 16.7% were classified as having possible depression. Most of the participants (88%) reported having a partner and of these, 78% reported being extremely happy. On average, relationship quality was 23.84±2.7 (range:7-28), the social support score was 22.3±3.0 (range:5-31) and stress score was 18.6±4.5 (range 12-43). Women with GWG outside the recommended range had significantly higher stress scores compared to women who gained within the recommended range (p=0.0012). The significant finding persisted after adjustment for race and education (p=0.0019). There was no significant association between GWG and the other psychosocial factors. Conclusions: Women with higher stress were less likely to gain within the IOM recommended range.