Maternal and Child Health Journal

, Volume 20, Issue 9, pp 1980–1988 | Cite as

Baseline Demographic, Anthropometric, Psychosocial, and Behavioral Characteristics of Rural, Southern Women in Early Pregnancy

  • Jessica L. ThomsonEmail author
  • Lisa M. Tussing-Humphreys
  • Melissa H. Goodman
  • Sarah Olender


Objectives Beginning life in a healthy uterine environment is essential for future well-being, particularly as it relates to chronic disease risk. Baseline (early pregnancy) demographic, anthropometric (height and weight), psychosocial (depression and perceived stress), and behavioral (diet and exercise) characteristics of rural, Southern, pregnant women enrolled in a maternal, infant, and early childhood home visiting program are described. Methods Participants included 82 women early in their second trimester of pregnancy and residing in three Lower Mississippi Delta counties in the United States. Baseline data were collected through direct measurement and surveys. Results Participants were primarily African American (96 %), young (mean age = 23 years), single (93 %), and received Medicaid (92 %). Mean gestational age was 18 weeks, 67 % of participants were overweight or obese before becoming pregnant, and 16 % tested positive for major depression. Participants were sedentary (mean minutes of moderate intensity physical activity/week = 30), had low diet quality (mean Healthy Eating Index-2010 total score = 43 points), with only 38, 4, and 7 % meeting recommendations for saturated fat, fiber, and sodium intakes, respectively. Conclusions for Practice In the Lower Mississippi Delta, there is a need for interventions that are designed to help women achieve optimal GWG by improving their diet quality and increasing the amount of physical activity performed during pregnancy. Researchers also should consider addressing barriers to changing health behaviors during pregnancy that may be unique to this region of the United States.


Early pregnancy Diet quality Physical activity Gestational weight gain African American 



We thank Debra Johnson, Shakari Moore, and Donna Ransome for their research support, and all the participants for giving their time generously to this project. This research is supported by the United States (US) Department of Agriculture, Agricultural Research Service Project 6001-53000-001-00D, and in kind support from the Delta Health Alliance. The views expressed are solely those of the authors and do not reflect the official policy or position of the US government.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Abu-Saad, K., & Fraser, D. (2010). Maternal nutrition and birth outcomes. Epidemiologic Reviews, 32, 5–25. doi: 10.1093/epirev/mxq001.CrossRefPubMedGoogle Scholar
  2. 2.
    Barker, D. J. P. (1998). Mothers, babies, and health in later life. London: Churchill Livingstone.Google Scholar
  3. 3.
    Flegal, K. M., Carroll, M. D., Kit, B. K., et al. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. Journal of the American Medical Association, 307(5), 491–497. doi: 10.1001/jama.2012.39.CrossRefPubMedGoogle Scholar
  4. 4.
    Modder J, Fitzsimon K(2010). CMACE/RCOG joint guideline: Managment of women with obesity in pregnancy. London: Centre for Maternity and Child Enquiries/Royal College of Obstetricians and Gynaecologists (CMAC/RCOG).Google Scholar
  5. 5.
    Wojcicki, J. M. (2011). Maternal prepregnancy body mass index and initiation and duration of breastfeeding: a review of the literature. Journal of Women’s Health., 20(3), 341–347. doi: 10.1089/jwh.2010.2248.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Rasmussen, K. M., Dieterich, C. M., Zelek, S. T., et al. (2011). Interventions to increase the duration of breastfeeding in obese mothers: The Bassett Improving Breastfeeding Study. Breastfeeding Medicine., 6(2), 69–75. doi: 10.1089/bfm.2010.0014.CrossRefPubMedGoogle Scholar
  7. 7.
    Institute of Medicine, National Research Council. (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academies Press.Google Scholar
  8. 8.
    DeVader, S. R., Neeley, H. L., Myles, T. D., et al. (2007). Evaluation of gestational weight gain guidelines for women with normal prepregnancy body mass index. Obstetrics and Gynecology, 110(4), 745–751. doi: 10.1097/01.AOG.0000284451.37882.85.CrossRefPubMedGoogle Scholar
  9. 9.
    Hedderson, M. M., Gunderson, E. P., & Ferrara, A. (2010). Gestational weight gain and risk of gestational diabetes mellitus. Obstetrics and Gynecology, 115(3), 597–604. doi: 10.1097/AOG.0b013e3181cfce4f.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Thorsdottir, I., Torfadottir, J. E., Birgisdottir, B. E., et al. (2002). Weight gain in women of normal weight before pregnancy: Complications in pregnancy or delivery and birth outcome. Obstetrics and Gynecology, 99(5 Pt 1), 799–806.PubMedGoogle Scholar
  11. 11.
    Morken, N. H., Klungsoyr, K., Magnus, P., et al. (2013). Pre-pregnant body mass index, gestational weight gain and the risk of operative delivery. Acta Obstetrics and Gynecology Scandinavia., 92(7), 809–815. doi: 10.1111/aogs.12115.CrossRefGoogle Scholar
  12. 12.
    Viswanathan, M., Siega-Riz, A. M., Moos, M. K., et al. (2008). Outcomes of maternal weight gain. Evidence Report/Technology Assessment., 168, 1–223.PubMedGoogle Scholar
  13. 13.
    Rooney, B. L., & Schauberger, C. W. (2002). Excess pregnancy weight gain and long-term obesity: One decade later. Obstetrics and Gynecology, 100(2), 245–252.PubMedGoogle Scholar
  14. 14.
    Christian, L. M. (2012). Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions. Progress in Neurobiology, 99(2), 106–116. doi: 10.1016/j.pneurobio.2012.07.003.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Field, T., Diego, M., Hernandez-Reif, M., et al. (2009). Depressed pregnant black women have a greater incidence of prematurity and low birthweight outcomes. Infant Behavior and Development., 32(1), 10–16. doi: 10.1016/j.infbeh.2008.09.005.CrossRefPubMedGoogle Scholar
  16. 16.
    Thomson, J. L., Tussing-Humphreys, L. M., & Goodman, M. H. (2014). Delta Healthy Sprouts: A randomized comparative effectiveness trial to promote maternal weight control and reduce childhood obesity in the Mississippi Delta. Contemporary Clinical Trials., 38(1), 82–91. doi: 10.1016/j.cct.2014.03.004.CrossRefPubMedGoogle Scholar
  17. 17.
    Feskanich, D., Sielaff, B. H., Chong, K., et al. (1989). Computerized collection and analysis of dietary intake information. Computer Methods and Programs in Biomedicine, 30(1), 47–57.CrossRefPubMedGoogle Scholar
  18. 18.
    Harnack, L., Stevens, M., Van Heel, N., et al. (2008). A computer-based approach for assessing dietary supplement use in conjunction with dietary recalls. Journal of Food Composition and Analysis, 21(Supplement 1), S78–S82. doi: 10.1016/j.jfca.2007.05.004.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Guenther, P. M., Casavale, K. O., Reedy, J., et al. (2013). Update of the Healthy Eating Index: HEI-2010. Journal of the Academy of Nutrition and Dietetics., 113(4), 569–580. doi: 10.1016/j.jand.2012.12.016.CrossRefPubMedGoogle Scholar
  20. 20.
    Hacker, A. N., Fung, E. B., & King, J. C. (2012). Role of calcium during pregnancy: Maternal and fetal needs. Nutrition Reviews, 70(7), 397–409. doi: 10.1111/j.1753-4887.2012.00491.x.CrossRefPubMedGoogle Scholar
  21. 21.
    Institute of Medicine. (2013). Dietary reference intakes tables and applications. Accessed 20 Apr 2015.
  22. 22.
    Jiang, X., West, A. A., & Caudill, M. A. (2014). Maternal choline supplementation: A nutritional approach for improving offspring health? Trends in Endocrinology and Metabolism, 25(5), 263–273. doi: 10.1016/j.tem.2014.02.001.CrossRefPubMedGoogle Scholar
  23. 23.
    Qiu, C., Coughlin, K. B., Frederick, I. O., et al. (2008). Dietary fiber intake in early pregnancy and risk of subsequent preeclampsia. American Journal of Hypertension, 21(8), 903–909. doi: 10.1038/ajh.2008.209.CrossRefPubMedGoogle Scholar
  24. 24.
    Reynolds, C. M., Vickers, M. H., Harrison, C. J., et al. (2014). High fat and/or high salt intake during pregnancy alters maternal meta-inflammation and offspring growth and metabolic profiles. Physiological Reports,. doi: 10.14814/phy2.12110.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Chasan-Taber, L., Schmidt, M. D., Roberts, D. E., et al. (2004). Development and validation of a Pregnancy Physical Activity Questionnaire. Medicine and Science in Sports and Exercise, 36(10), 1750–1760.CrossRefPubMedGoogle Scholar
  26. 26.
    Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396.CrossRefPubMedGoogle Scholar
  27. 27.
    Radloff, L. S. (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  28. 28.
    IMG Health Publications. (2015, July). Pregnancy corner. Accessed 21 May 2015.
  29. 29.
    US Department of Health and Human Services. (2008). 2008 physical activity guidelines for Americans. Washington DC: US Government Printing Office.Google Scholar
  30. 30.
    The Lower Mississippi Delta Nutrition Intervention Research Consortium. (2004). Self-reported health of residents of the Mississippi Delta. Journal of Health Care for the Poor and Underserved, 15(4), 645–662.CrossRefGoogle Scholar
  31. 31.
    United Health Foundation. (2014). America’s Health Rankings. Accessed 27 Apr 2015.
  32. 32.
    American College of Sports Medicine. (2006). Impact of physical activity during pregnancy and postpartum on chronic disease risk. Medicine and Science in Sports and Exercise, 38(5), 989–1006. doi: 10.1249/01.mss.0000218147.51025.8a.CrossRefGoogle Scholar
  33. 33.
    Jackson, F. M., Rowley, D. L., & Curry Owens, T. (2012). Contextualized stress, global stress, and depression in well-educated, pregnant, African–American women. Women’s Health Issues, 22(3), e329–e336. doi: 10.1016/j.whi.2012.01.003.CrossRefPubMedGoogle Scholar
  34. 34.
    Keenan, K., Hipwell, A. E., Bortner, J., et al. (2014). Association between fatty acid supplementation and prenatal stress in African Americans: A randomized controlled trial. Obstetrics and Gynecology, 124(6), 1080–1087. doi: 10.1097/AOG.0000000000000559.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York (outside the USA) 2016

Authors and Affiliations

  • Jessica L. Thomson
    • 1
    Email author
  • Lisa M. Tussing-Humphreys
    • 2
  • Melissa H. Goodman
    • 1
  • Sarah Olender
    • 2
  1. 1.United States Department of AgricultureAgricultural Research ServiceStonevilleUSA
  2. 2.Department of Medicine and Cancer CenterUniversity of Illinois at ChicagoChicagoUSA

Personalised recommendations