Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain☆

Objective The research addresses two questions: Are potentially modifiable psychosocial and behavioral factors related to gestational weight gain? Do the same factors relate to both excessive and insufficient weight gain? Design Prospective cohort study that followed women from early pregnancy until two years postpartum. Data were collected through mailed questionnaires and an audit of the medical record. Subjects/setting The sample included 622 healthy adult women who gave birth to live singleton infants. Subjects were recruited from all women who registered for prenatal care in a hospital and primary care clinic system serving a 10-county area of Upstate New York. Statistical analyses performed Multiple linear and logistic regression with adjustment for timing of measurements and length of gestation were performed. Results Only 38% of women gained an amount of weight in pregnancy that was within the range recommended by the Institute of Medicine. Valid and easily implemented measures of change in food intake and physical activity from prepregnancy and cigarette smoking during pregnancy were each significantly (P<.05) and independently related to gestational weight gain. Along with other variables in a biopsychosocial regression model, these variables accounted for 27% of the variance in gestational weight gain and were also significantly related to risk of inadequate and excessive gain. Applications/conclusions The findings facilitate the design of more effective nutrition interventions to promote appropriate gestational weight gain and the long-term health of women and their infants. J Am Diet Assoc. 2003;103:48-54.