Maternal and Child Health Journal

, Volume 10, Issue 1, pp 55–62 | Cite as

Factors Influencing Inadequate and Excessive Weight Gain in Pregnancy: Colorado, 2000–2002

  • Chris S. Wells
  • Renee Schwalberg
  • Gretchen Noonan
  • Vivian Gabor
Article

Objectives: To identify the biological, psychosocial, and behavioral characteristics that are associated with inadequate and/or excessive weight gain in pregnancy. Methods: Univariate, bivariate, and multiple logistic regression analyses were conducted using data from Colorado's 2000–2002 Pregnancy Risk Assessment Monitoring System (PRAMS). Independent variables included biological risk factors (prepregnancy BMI, parity, preterm labor, maternal morbidity), psychosocial risk factors (pregnancy intention, WIC and Medicaid enrollment, area of residence, age, race/ethnicity, education, and stressors), and behavioral risk factors (smoking and drinking alcohol in the last trimester of pregnancy). Results: In the bivariate analysis, all the biological risk factors were significantly associated with the pregnancy weight gain distribution, as were several of the psychosocial risk factors (WIC and Medicaid enrollment, area of residence, race/ethnicity, and maternal education). Smoking and alcohol use were not significant. After controlling for other variables through logistic regression, the only characteristics associated with inadequate weight gain were parity, underweight or obesity, preterm labor, nausea, residence in a rural area, low levels of education, and smoking. The characteristics associated with excessive weight gain were overweight or obesity, high blood pressure, and having 12 years of education. Conclusion: Having a pre-pregnancy BMI above 29 greatly increases the risk for both inadequate and excessive weight gain. Unfortunately, obesity, like the other major risk factors identified here (maternal education and parity) are not modifiable after a given pregnancy begins. To address these problems, a sustained approach to women's health, education, and well-being across the lifespan will be required, rather than a reliance upon targeted interventions during pregnancy.

KEY WORDS:

pregnancy weight gain BMI obesity 

REFERENCES

  1. 1.
    Subcommittee on Nutritional Status and Weight Gain During Pregnancy, Institute of Medicine, National Academy of Sciences. Nutrition during pregnancy. Washington, DC: National Academy Press, 1990.Google Scholar
  2. 2.
    Hickey CA, Cliver SP, McNeal SF, Hoffman HJ, Goldenberg RL. Prenatal weight gain patterns and birth weight among nonobese black and white women. Obstet Gynecol 1996;88 (4 Pt 1):490–496.CrossRefPubMedGoogle Scholar
  3. 3.
    Luke B, Hediger ML, Scholl TO. Point of diminishing returns: When does gestational weight gain cease benefiting birthweight and begin adding to maternal obesity? J Matern Fetal Med 1996;5(4):168–173.CrossRefPubMedGoogle Scholar
  4. 4.
    Strychar IM, Chabot C, Champagne F, Ghadirian P, Leduc L, Lemonnier MC, Raynauld P. Psychosocial and lifestyle factors associated with insufficient and excessive maternal weight gain during pregnancy. J Am Diet Assoc 2000;100(3):353–356.CrossRefPubMedGoogle Scholar
  5. 5.
    Caulfield LE, Witter FR, Stoltzfus RJ. Determinants of gestational weight gain outside the recommended ranges among black and white women. Obstet Gynecol 1996;87(5 Pt 1):760–765.CrossRefPubMedGoogle Scholar
  6. 6.
    Hickey CA. Sociocultural and behavioral influences on weight gain during pregnancy. Am J Clin Nutr 2000;71(suppl): 1364S–1370S.PubMedGoogle Scholar
  7. 7.
    Carmichael S, Abrams B, Selvin S. The pattern of maternal weight gain in women with good pregnancy outcomes. Am J Public Health 1997;87:1984–1988.PubMedCrossRefGoogle Scholar
  8. 8.
    Hickey CA, Cliver SP, Goldenberg RL, McNeal SF, Hoffman HJ. Low prenatal weight gain among low-income women: What are the risk factors? Birth 1997;24(2):102–108PubMedCrossRefGoogle Scholar
  9. 9.
    Hickey CA, Cliver SP, Goldenberg RL, Kohatsu J, Hoffman HJ. Prenatal weight gain, term birth weight, and fetal growth retardation among high-risk multiparous black and white women. Obstet Gynecol 1993;81(4):529–535.PubMedGoogle Scholar
  10. 10.
    Lederman SA, Alfasi G, Deckelbaum RJ. Pregnancy-associated obesity in black women in New York City. Matern Child Health J 2002;6(1):37–42.CrossRefPubMedGoogle Scholar
  11. 11.
    Strychar IM, Chabot C, Champagne F, Ghadirian P, Leduc L, Lemonnier MC, Raynauld P. Psychosocial and lifestyle factors associated with insufficient and excessive maternal weight gain during pregnancy. J Am Diet Assoc 2000;100(3):353–356.CrossRefPubMedGoogle Scholar
  12. 12.
    Chamberlain G, (Eds.) Turnbull's obstetrics. 2nd edn. New York: Churchill Livingstone, 1995.Google Scholar
  13. 13.
    Villanueva EV. The validity of self-reported weight in US adults: A population based cross-sectional study. BMC Public Health 2001;1(1):11.CrossRefPubMedGoogle Scholar
  14. 14.
    Jeffrey R. Bias in reported body weight as a function of education, occupation, health and weight concern. Addict Behav 1996;21:217–222.CrossRefPubMedGoogle Scholar
  15. 15.
    Palta M, Prineas RJ, Berman R, Hannan P. Comparison of self-reported and measured height and weight. Am J Epidemiol 1982;115(2):223–230.PubMedGoogle Scholar
  16. 16.
    Cameron R, Evers S. Self-reported issues in obesity and weight management: State of the art and future directions. Behav Assess 1990;12:91–106.Google Scholar
  17. 17.
    Buescher PA, Taylor KP, Davis MH, Bowling JM. The quality of the new birth certificate data: A validation study in North Carolina. Am J Public Health 1993;83(8):1163–1165.PubMedGoogle Scholar
  18. 18.
    Reichmann NE, Hade EM. Validation of birth certificate data: A study of women in New Jersey's HealthStart program. Ann Epidemiol 2001;11(3):186–193.CrossRefPubMedGoogle Scholar
  19. 19.
    Piper JM, Mitchell EF, Snowden M, Hall C, Adams M, Taylor P. Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records. Am J Epidemiol 1993;137(7):758–768.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Chris S. Wells
    • 1
    • 3
  • Renee Schwalberg
    • 2
  • Gretchen Noonan
    • 2
  • Vivian Gabor
    • 2
  1. 1.Colorado Department of Public Health and EnvironmentHealth Statistics Section, Center for Health and Environmental Information and StatisticsDenverUSA
  2. 2.Maternal  and  Child  Health  Information  Resource  CenterWashingtonUSA
  3. 3.Colorado Department of Public Health and EnvironmentHealth Statistics Section, Center for Health and Environmental Information and StatisticsDenverUSA

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