Weight Stigma, Dietary Behavior and Gestational Weight Gain Among Women with High Pre-Pregnancy Body Mass Index
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Abstract
This descriptive correlational study aimed to examine the relationship between weight stigma, dietary behavior, and gestational weight gain. The sample consisted of pregnant women aged 20 years and older, with a gestational age of 20 to 40 weeks, and a pre-pregnancy BMI classified as high. A total of 90 participants were free from any conditions or diseases related to abnormal weight gain and received antenatal care at Uttaradit Hospital and Phrae Hospital between January and September 2024. The research instruments included the Thai version of the Weight Self-stigma Questionnaire and the Food Consumption During Pregnancy Questionnaire. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.
The results revealed that the majority of the sample, 81.11%, experienced weight gain exceeding the recommended levels, while 18.89% gained weight within the recommended range. the average total score for weight stigma among the sample was 36.04 (SD = 6.86), and the average total score for dietary behavior was 80.74 (SD = 4.84). weight stigma was found to have a low positive correlation with gestational weight gain, with statistical significance (r = .220, p ≤ .05). Conversely, dietary behavior showed a low negative correlation with gestational weight gain, with statistical significance (r = -.256, p ≤ .05).
It is recommended to promote appropriate dietary behaviors among women with a high pre-pregnancy BMI. Nursing care should be provided in a manner that avoids language or behaviors that could imply blame or discrimination based on their weight, ensuring a supportive and non-judgmental approach for pregnant women.
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References
Akgun, N., Keskin, H. L., Ustuner, I., Pekcan, G. & Avsar, A. F. (2017). Factors affecting pregnancy weight gain and relationships with
maternal/fetal outcomes in Turkey. Saudi Medical Journal, 38(5), 503-508.
Antenatal Care Unit, Phrae Hospital. (2022). Annual statistics of antenatal care services. Phrae Hospital.
Antenatal Care Unit, Uttaradit Hospital. (2022). Annual statistics of antenatal care services. Uttaradit Hospital.
Asefa, F., Cummins, A., Dessie, Y., Foureur, M. & Hayen, A. (2021). Patterns and predictors of gestational weight gain in Addis Ababa,
central Ethiopia: a prospective cohort study. Reproductive Health, 18, 1-14.
Chirawat, P., Kamolthip, R., Rattaprach, R., Nadhiroh, S. R., Tung, S. E. H., Gan, W. Y., Pinyo, M., Nabpran, T., Rozzell-Voss, K. N., Latner, J.
D. & Lin, C. Y. (2022). Weight stigma among young adults in Thailand: reliability, validation, and measurement invariance of the
Thai-translated weight self stigma questionnaire and perceived weight stigma scale. International Journal of Environmental
Research and Public, 19(23), 1-13.
Choi, H., Lim, J. Y., Lim, N. K., Ryu, H. M., Kwak, D. W., Chung, J. H., Park, H. J. & Park, H. Y. (2022). Impact of pre-pregnancy body mass
index and gestational weight gain on the risk of maternal and infant pregnancy complications in Korean women. International
Journal of Obesity, 46(1), 59-67.
Christenson, A., Torgerson, J. & Hemmingsson, E. (2020). Attitudes and beliefs in Swedish midwives and obstetricians towards obesity
and gestational weight management. BMC Pregnancy Childbirth, 20, 1-9.
Chuang, C. H., Stengel, M. R., Hwang, S. W., Velott, D., Kjerulff, K. H. & Kraschnewski, J. L. (2014). Behaviours of overweight and obese
women during pregnancy who achieve and exceed recommended gestational weight gain. Obesity Research & Clinical Practice,
(6), e577-e583.
Cliffer, I., Darling, A. M., Madzorera, I., Wang, D., Perumal, N., Wang, M., Liu, E., Pembe, A. B., Urassa, W. & Fawzi, W. W. (2023).
Associations of diet quality, socioeconomic factors, and nutritional status with gestational weight gain among pregnant women in
Dar es Salaam, Tanzania. Current Developments in Nutrition, 7(3), 1-11.
Cohen, J. (1992). A power primer. Psychological Bulletin, 122(1), 155-159.
Cummings, J. R., Lipsky, L. M., Schwedhelm, C., Liu, A. & Nansel, T. R. (2022). Associations of ultra-processed food intake with maternal
weight change and cardiometabolic health and infant growth. International Journal of Behavioral Nutrition and Physical Activity,
, 1-11.
Dalfrà, M. G., Burlina, S. & Lapolla, A. (2022). Weight gain during pregnancy: a narrative review on the recent evidences. Diabetes
Research and Clinical Practice, 188, 1-8.
Dieterich, R., Demirci, J., & Danford, C. (2020). Weight stigma related to pregnancy: a concept analysis. Advances in Nursing Science,
(2), 190-199.
Fitzsimons, K. J., Modder, J. & Greer, I. A. (2009). Obesity in pregnancy: risks and management. Obstetric Medicine, 2(2), 52-62.
Flannery, C., Mtshede, M. N., McHugh, S., Anaba, A. E., Clifford, E., O’Riordan, M., Kenny, L. C., McAuliffe, F. M., Kearney, P. M. &
Matvienko-Sikar, K. (2020). Dietary behaviours and weight management: a thematic analysis of pregnant women's perceptions.
Maternal & Child Nutrition, 16(4), 1-10.
Flynn, A. C., Seed, P. T., Patel, N., Barr, S., Bell, R., Briley, A. L., Godfrey, K. M., Nelson, S. M., Oteng-Ntim, E., Robinson, S. M., Sanders, T. A,
Sattar, N., Wardle, J., Poston, L. & Goff, L. M. (2016). Dietary patterns in obese pregnant women; influence of a behavioral
intervention of diet and physical activity in the UPBEAT randomized controlled trial. International Journal of Behavioral Nutrition
and Physical Activity, 13, 1-12.
Gettong, N. & Rujiraprasert, N. (2018). Overweight during pregnancy: an issue to be considered for nurse-midwifery, 41(3), 128-137. (in
Thai).
Goldstein, R. F., Abell, S. K., Ranasinha, S., Misso, M. L., Boyle, J. A., Harrison, C. L., Black, M. H., Li, N., Hu, G., Corrado, F., Hegaard, H., Kim, Y. J., Haugen, M., Song, W. O., Kim, M. H., Bogaerts, A., Devlieger, R., Chung, J. H. & Teede, H. J. (2018). Gestational weight gain
across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million
women. BMC Medicine, 16, 1-14.
Gudipally, M., Farooq, F., Basany, K., Haggerty, C. L., Tang, G., Kusneniwar, G. N., Jammy, G. R., Bunker, C. H. & Reddy, P. S. (2023). Impact
of prepregnancy body mass index on adverse pregnancy outcomes: analysis from the longitudinal Indian family health cohort
study. AJOG Global Reports, 3(1), 1-10.
Hill, B. & Incollingo Rodriguez, A. C. (2021). Weight stigma across the preconception, pregnancy, and postpartum periods: a narrative
review and conceptual model. Seminars in Reproductive Medicine, 38(6), 414-422.
Hill, I. F., Angrish, K., Nutter, S., Ramos-Salas, X., Minhas, H. & Nagpal, T. S. (2023). Exploring body dissatisfaction in pregnancy and the
association with gestational weight gain, obesity, and weight stigma. Midwifery, 119, 1-6.
Hodgkinson, E. L., Smith, D. M. & Wittkowski, A. (2014). Women’s experiences of their pregnancy and postpartum body image: a
systematic review and meta-synthesis. BMC Pregnancy and Childbirth, 14, 1-11.
Incollingo Rodriguez, A. C., Dunkel Schetter, C., Brewis, A. & Tomiyama, A. J. (2019). The psychological burden of baby weight:
pregnancy, weight stigma, and maternal health. Social Science & Medicine, 235, 1-10.
Incollingo Rodriguez, A. C., Tomiyama, A. J., Guardino, C. M. & Dunkel Schetter, C. (2019). Association of weight discrimination during
pregnancy and postpartum with maternal postpartum health. Health Psychology, 38(3), 226-237.
Kaewsiri, P., Faramee, P., Onpiw, N. & Ansook, P. (2023). Factors predicting gestational weight gain among pregnant women with high
pre-pregnancy body mass index. Journal of Nursing and Education, 16(3), 48-60. (in Thai).
Ketchum, K. & Jevitt, C. M. (2024). Evidence-based eating patterns and behavior changes to limit excessive gestational weight gain: a
scoping review. International Journal of Environmental Research and Public Health, 21(1), 1-29.
Langley-Evans, S. C. (2022). Early life programming of health and disease: the long-term consequences of obesity in pregnancy. Journal
of Human Nutrition and Dietetics, 35(5), 816-832.
Lillis, J., Luoma, J. B., Levin, M. E. & Hayes, S. C. (2010). Measuring weight self-stigma: the weight self-stigma questionnaire. Obesity,
(5), 971-976.
Lindsay, K. L., Heneghan, C., McNulty, B., Brennan, L. & McAuliffe, F. M. (2015). Lifestyle and dietary habits of an obese pregnant cohort.
Maternal and Child Health Journal, 19, 25-32.
Mulherin, K., Miller, Y. D., Barlow, F. K., Diedrichs, P. C. & Thomson, R. (2013). Weight stigma in maternity care: women’s experiences and care providers’ attitudes. BMC Pregnancy Childbirth, 13, 1-13.
Nagpal, T. S., Nippert, K. E., Velletri, M., Tomiyama, A. J. & Incollingo Rodriguez, A. C. (2023). Close relationships as sources of pregnancy-
related weight stigma for expecting and new mothers. International Journal of Behavioral Medicine, 30, 297–303.
Ojha, S., Budge, H. & Symonds, M. E. (2014). Adipocytes in normal tissue biology. Retrieved (2023, March 30). from
https://doi.org/10.1016/B978-0-12-386456-7.04408-7
Olafsdottir, A. S., Skuladottir, G. V., Thorsdottir, I., Hauksson, A. & Steingrimsdottir, L. (2006). Maternal diet in early and late pregnancy in
relation to weight gain. International Journal of Obesity, 30(3), 492-499.
Polit, D. F., & Beck, C. T. (2017). Nursing research: generating and assessing evidence for nursing practice (10th ed.). Philadelphia:
Wolters Kluwer.
Pongcharoen, T., Gowachirapant, S., Wecharak, P., Sangket, N. & Winichagoon, P. (2016).
Pre-pregnancy body mass index and gestational weight gain in Thai pregnant women as risks for low birth weight and
macrosomia. Asia Pacific Journal of Clinical Nutrition, 25(4), 810-870.
Puhl, R. M. & Brownell, K. D. (2006). Confronting and coping with weight stigma: an investigation of overweight and obese adults.
Obesity, 10(14), 1802-1815.
Reichetzeder, C. (2021). Overweight and obesity in pregnancy: their impact on epigenetics. European Journal of Clinical Nutrition, 75,
-1722.
Satarak, P., Oangkanawin, P. & Pachasaisoradej, K. (2019). Guidelines for weight control behaviors during pregnancy in women with an
over pre-pregnancy body mass index. Nursing Journal of the Ministry of Public Health, 29(3), 171–178. (in Thai).
Skouteris, H. (2012). Pregnancy: physical and body image changes. Retrieved (2023, March 30). from https://doi.org/10.1016/B978-0-12-
-0.00105-X
Srisatisnarakul, B. (2020). Effect size, power analysis, optimal sample size calculations using G*Power software. Chulalongkorn
University Press. (in Thai).
Stirrat, L. I. & Reynolds, R. M. (2014). Effect of maternal obesity on early and long-term outcomes for offspring. Research and Reports in
Neonatology, 4, 43-53.
Stok, F. M., Renner, B., Allan, J., Boeing, H., Ensenauer, R., Issanchou, S., Kiesswetter, E., Lien, N., Mazzocchi, M., Monsivais, P., Stelmach-
Mardas, M., Volkert, D. & Hoffmann, S. (2018). Dietary behavior: an interdisciplinary conceptual analysis and taxonomy. Frontiers
in Psychology, 9, 1-12.
Stupin, J. H. & Arabin, B. (2014). Overweight and obesity before, during and after pregnancy. Geburtshilfe Frauenheilkd, 74(7), 639-645.
Tebbani, F., Oulamara, H. & Agli, A. (2021). Food diversity and nutrient intake during pregnancy in relation to maternal weight gain.
Nutrition Clinique et Métabolisme, 35(2), 93-99.
Thau, L., Gandhi, J. & Sharma, S. (2022). Physiology, cortisol. Retrieved (2023, March 30). from
https://www.ncbi.nlm.nih.gov/books/NBK538239/
Wu, Y., Li, D. & Vermund, S. H. (2024). Advantages and limitations of the body mass index (BMI) to assess adult obesity. International
Journal of Environmental Research and Public Health, 21(6), 1-12.
Yang, M., Feng, Q., Chen, C., Chen, S., Guo, Y., Su, D., Chen, H., Sun, H., Dong, H. & Zeng, G. (2023). Healthier diet associated with reduced risk of excessive gestational weight gain: a Chinese prospective cohort study. Maternal & Child Nutrition, 19(3), 1-15.
Yong, H. Y., Mohd Shariff, Z., Mohd Yusof, B. N., Rejali, Z., Tee, Y. Y. S., Bindels, J. & van der Beek, E. M. (2019). Pre-pregnancy BMI
influences the association of dietary quality and gestational weight gain: the SECOST study. International Journal of
Environmental Research and Public Health, 16(19), 1-12.
Zhang, J., Wang, X., Zhu, P., Huang, X., Cao, X. & Li, J. (2024). Exploring the relationships between pre-pregnancy BMI, gestational weight
gain, and nutritional intake: a real-world investigation in Shandong, China. PeerJ, 12, 1-14.
Zhou, M., Peng, X., YI, H., Tang, S. & You, H. (2022). Determinants of excessive gestational weight gain: a systematic review and meta-
analysis. Archives of Public Health, 80, 1-12.
