The Importance Of Gestational Weight Gain And Psychosocial Factors To Postpartum Changes In Maternal Body Weight, And Applications Of Prospect Theory To Understanding Women’S Conceptualization Of Weight Change

摘要

This research sought to examine the contribution of pregnancy and psychosocial factors to weight change in women of reproductive age using two approaches. The first involved analysis of data from a prospective cohort study of women who were followed from pregnancy until 2 years postpartum. From these data, the natural history of weight change between one and two years postpartum was examined, and the associations of this weight change with prenatal self-efficacy and locus of control, and postpartum dietary and physical activity variables were explored. The second approach used a survey designed to test the potential applications of Prospect Theory to individuals' conceptualization of weight change in a sample of adult women. The results from the cohort study indicated that average late postpartum weight change was approximately zero, but with considerable variation, with more than half of the sample gaining weight in this period. One-year weight retention was inversely related to later weight change, and to risk of later weight gain. Prenatal self-efficacy and locus of control were positively associated with fruit and vegetable intake and exercise frequency at two years postpartum. Self- efficacy was inversely associated with weight retention at 1 year postpartum, which was in turn inversely related to later weight change and the likelihood of returning to early pregnancy body weight. There was a positive association between prenatal self-efficacy and likelihood of returning to early pregnancy body weight. Results from the survey examining Prospect Theory showed that ratings of importance and likelihood of changing behaviors to prevent weight gain above 5 lb were higher, and difficulty ratings were lower, than those for producing weight loss above 5 lb, although importance and likelihood ratings for preventing 2 - 5 lb of weight gain were lower than those for producing 2 - 5 lb of weight loss. Importance and difficulty ratings were associated with current body size and likelihood of changing behaviors to produce weight change. Overall, these findings suggest the importance of increased attention to advocating the prevention of weight gain, especially among individuals who are currently at a healthy body weight, to prevent obesity development in women of reproductive age.