The Role of Health-related Behaviors in Gestational Weight Gain among Women with Overweight and Obesity: A Cross-sectional Analysis

Abstract

Objective To evaluate the influence of health-related behaviors including food intake, physical activity, sleep time, smoking habits, stress, depression, and optimism on excessive gestational weight gain (GWG) among women with overweight and obesity. Methods A cross-sectional study was conducted at the Women's Hospital of the Universidade de Campinas, Campinas, state of São Paulo, Brazil, with 386 mediate postpartum women that fit the inclusion criteria of ≥ 19 years old, first prenatal care visit at or before 14 weeks, and single live baby. Dietary habits, physical exercise practice, sleep duration, smoking and alcohol habits were self-reported. Psychosocial history was evaluated using the Edinburgh Postpartum Depression Scale (EPDS), Perceived Stress Scale (PSS), and Life Orientation Test-Revised (LOT-R). Sociodemographic, obstetric, anthropometric, and neonatal data were retrieved from medical records. Descriptive statistics and stepwise logistic regression were performed. Results The prevalence of overweight and obesity was 29.27% and 24.61%, respectively, according to the body mass index (BMI). Excessive GWG was observed in 47.79% of women with overweight and in 45.26% of women with obesity. Excessive GWG among overweight and obese women was associated with inadequate vegetable and bean consumption (odds ratio [OR] = 2.95, 95% confidence interval [CI]: 1.35–6.46 and OR = 1.91; 95%CI: 1.01–3.63, respectively) and stress (OR = 1.63; 95%CI 1.01–2.64). After adjustment by maternal age, multiparity, sleep duration, smoking, and alcohol intake, we found that stress (PSS ≥ 20) was associated with excessive GWG in women with overweight or obesity (OR: 1.75; 95%CI: 1.03–2.96). Conclusion Among women with overweight and obesity, stress is the main variable associated with excessive GWG. Inadequate vegetables and beans consumption also showed association with excessive GWG.

Factors associated with gestational weight gain above recommended: systematic review / Fatores associados ao ganho de peso gestacional acima do recomendado: revisão sistemática

“…Other factors identified in this review regarding gestational weight gain were socioeconomic status, 3,15,19 maternal age over 20 years, 17,19 parity, 17,21 and others were identified in only one study, such as smoking, 19 work, 2 schooling, 14 stress, 18 single fetus, 19 neighborhood violence, 20 planned weight gain above guidelines. 21 Table 1 also shows the quality assessment of the studies performed using the JBI "JBI Critical Appraisal Checklist", in which they were classified as low and moderate risk of bias.…”

“…20 Most of the selected studies were produced in the USA 14,16,19,20 and Brazil. 2,3,17,18 Among the studies analyzed, the factor that was present in a greater number of articles was weight during the prepregnancy period. 3,[14][15][16][17]19,21 Pregnant women who were overweight or obese before pregnancy were more likely to have high weight gain compared to eutrophic pregnant women.…”

O Patrimônio Natural À Luz Da Abordagem One Health

“…Há estudos que relacionam o estresse e o menor período do sono como fatores favoráveis ao ganho de peso gestacional excessivo. O mesmo foi evidenciado nos ensaios clínicos analisados, apesar de que mais estudos devem ser realizados para esclarecer essa relação (KOMINIAREK et al, 2018;PAULINO et al, 2020).…”

The association between multidimensional sleep health and gestational weight gain: nuMoM2b Sleep Duration and Continuity Study

“…[12][13][14][15][16][17] In non-pregnant populations, poor sleep health indicators such as short or long sleep duration, early or late sleep timing, low sleep efficiency (a measure of continuous vs. interrupted sleep), and low sleep regularity across days are independently associated with obesity and weight gain. 18 Among the few studies examining associations between sleep and GWG, most, [19][20][21] but not all, 22 studies have found short sleep duration and perceived sleep deprivation to be associated with increased risk of low GWG (i.e., less than NAM guidelines).…”

“…Our findings that individuals’ sleep domains were not associated with GWG are consistent with the findings of some literature but conflict with others. 19–22, 46, 47 For example, Abeysena et al examined associations of self-reported sleep duration in the second and third trimesters and found sleeping <8 h/day (vs. >8 h/day) during the second, third, or both second and third trimesters was associated with higher odds of the IOM defined inadequate GWG (OR 1.60, 95% CI 1.05, 2.46) adjusting for the effect of body mass index and gestational age. 19 Likewise, Hill et al found that short sleep duration in late pregnancy was associated with higher odds of inadequate GWG (1.39; 1.03–1.87) and inversely associated with gestational fat gain (−0.36 – 0.16 0.02).…”