Prospective relationships between health cognitions and excess gestational weight gain in a cohort of healthy and overweight pregnant women

Background - Excess gestational weight gain (GWG) contributes to long term obesity in mothers and children. To guide the tailoring of interventions to prevent excess GWG, a better understanding is needed of the lifestyle-related health cognitions that influence women’s attempts to manage GWG. Objective - To examine the relationship between health cognitions and excess GWG for women who enter pregnancy at a healthy weight (BMI2) or overweight (BMI>25kg/m2). It was hypothesized that health cognitions with a positive [negative] influence on health behavior would be associated with lower [higher] likelihood of excess GWG and that specific associations would differ between weight status groups. Design - This prospective, observational study commenced when participants were Participants and setting - A consecutive sample of pregnant women (n=715) were recruited from an Australian metropolitan hospital between August 2010 and January 2011. All women Main outcome measures - Excess GWG defined according to Institute of Medicine 2009 recommendations and predisposing, reinforcing and enabling cognitions for lifestyle health behaviors. Statistical analyses performed - Logistic regression analyses examined associations between health cognitions and excess GWG stratified for pre-pregnancy weight status. Results - For healthy weight women higher weight locus of control scores were protective against excess GWG (OR [95%CI]) (0.6 [0.4-0.8]), whereas higher perceived risk scores (personal risk and risk arising from pre-pregnancy weight) (1.3[1.1-1.7]) were associated with excess GWG. For overweight women higher negative outcome expectation scores were associated with an increased risk of excess GWG (1.4[1.1-2.0]). Conclusions - Lifestyle-related health cognitions are associated with excess GWG and differed by pre-pregnancy weight status, suggesting the need to tailor behavior change interventions accordingly