Document Detail


Determinants of excessive gestational weight gain in urban, low-income women.
MedLine Citation:
PMID:  22818249     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Factors influencing excessive weight gain in pregnancy have not been well-studied among urban, low-income women.
METHODS: This prospective cohort study of 94 prenatal care patients at a large university hospital in Philadelphia examined associations of modifiable midpregnancy behaviors and nonmodifiable or early pregnancy factors with excessive gestational weight gain. Data were collected through questionnaires and medical record abstraction from 2009 to 2011.
FINDINGS: The majority of women were African American (83%) and all (100%) received Medicaid. Nearly two thirds (60%) were overweight or obese in early pregnancy and 41% experienced excessive gain. In multivariable logistic regression analyses, significant predictors of excessive gestational weight gain included high early pregnancy body mass index (odds ratio [OR], 4.20; 95% confidence interval [CI], 1.43-12.34 for overweight/obese vs. normal weight), nulliparity (OR, 3.35; 95% CI, 1.17-9.62 for nulliparity vs. multiparity), and clinician advice discordant with Institute of Medicine guidelines (OR, 5.88; 95% CI, 1.04-33.32 for discordant vs. concordant advice). Watching under 2 hours of television daily (OR, 0.18; 95% CI, 0.03-1.03), and engaging in regular physical activity during pregnancy (OR, 0.35; 95% CI, 0.11-1.09) were suggestive of a reduced risk of excessive gain.
CONCLUSIONS: In this sample of urban, low-income women, high early pregnancy body mass index, nulliparity, and discordant clinician advice were directly associated with excessive gestational weight gain, with a trend toward decreased risk for viewing fewer hours of television and engaging in regular physical activity. Intervening on these targets may optimize gestational weight gain and promote long-term maternal health.
Authors:
Sharon J Herring; Deborah B Nelson; Adam Davey; Alicia A Klotz; La Vette Dibble; Emily Oken; Gary D Foster
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Publication Detail:
Type:  Journal Article     Date:  2012-07-17
Journal Detail:
Title:  Women's health issues : official publication of the Jacobs Institute of Women's Health     Volume:  22     ISSN:  1878-4321     ISO Abbreviation:  Womens Health Issues     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-04     Completed Date:  2012-11-06     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  9101000     Medline TA:  Womens Health Issues     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e439-46     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Affiliation:
Center for Obesity Research and Education, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Body Mass Index
Confidence Intervals
Diet
Exercise
Female
Gestational Age
Humans
Life Style
Logistic Models
Medicaid
Odds Ratio
Overweight / complications
Philadelphia
Poverty*
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Prenatal Care*
Prospective Studies
Questionnaires
Risk Factors
Socioeconomic Factors
United States
Urban Population / statistics & numerical data*
Weight Gain*
Young Adult
Grant Support
ID/Acronym/Agency:
K23 HL106231/HL/NHLBI NIH HHS; K24 HD069408/HD/NICHD NIH HHS; L30 HL104554/HL/NHLBI NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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