ResultsTable 1 presents select sociodemographic, behavioral, anthropometric, dietary, physical activity and psychosocial characteristics of the sample. Approximately 20% of the women were African American, a majority reported being married (74%), having attained at least a college education (59%), and living well above the poverty level (75%). Half of the sample was age 30 or older and 48% were nulliparous. Eleven percent of women reported smoking at least 1 cigarette per day during the first two trimesters. Regarding gestational weight changes, participants gained an average of 15.1 kilograms and 64.2% gained in excess of clinical guidelines. Only 21% of women studied gained within the recommended ranges. Women’s activity levels decreased uniformly from early to late pregnancy.Table 1Table 1Characteristics of women in the Pregnancy, Infection, and Nutrition Study, 2001–2005 (N = 1605)Adequacy of GWG by Level of Psychosocial StatusTable 2 presents the crude and adjusted means for adequacy of GWG in the continuous form by psychosocial predictors in the categorical form. The Bonferroni-corrected results from unadjusted one-way ANOVA models showed that women scoring high in depressive symptoms at both <20 weeks (p = 0.05) and between 24–29 weeks (p = 0.03) gestation gained on average a significantly greater percentage of weight in excess of recommendations when compared to women reporting lower levels of depression at both assessments. However, even women endorsing few depressive symptoms on average gained in excess of clinical guidelines. It is worth noting that women classified as having gained an excessive amount of weight during the gestational period reported greater elevations of depressive symptoms than women who gained weight in adherence with clinical guidelines (p < 0.01; data not shown).Table 2Table 2Crude and Adjusted Means for Adequacy of Gestational Weight Gain Categorized by Psychosocial StatusGreater beliefs in chance as a controlling factor in the health of the fetus were marginally associated with higher mean adequacy of weight gain achieved (p = 0.06). Similar trends emerged for self-esteem (p = 0.08) and trait anxiety (p = 0.07) in the uncorrected models (see Table 2). As shown in Table 2, results from likelihood ratio chi-square tests yielded from multivariable linear regression models indicated that when adjusted for important covariates these relationships were attenuated. Overall, pregravid BMI appeared to be the confounder with the greatest impact on results. This is illustrated here for the association between CES-D (≤ 20 weeks) and adequacy of GWG: 1) without confounders: B = 0.007, p <0.001, 2) with pregravid BMI: B = 0.001, p = 0.002, 3) with parity: B = 0.008, p < 0.001, 4) with marital status: B = 0.005, p < 0.05, 5) with race: B = 0.006, p < 0.01, 6) with education: B =0.004, p < 0.05, 7) with smoking: B = 0.006, p < 0.01, 8) with total calories: B = 0.006, p < 0.01, 9) with indoor MET-Hrs (27–30 weeks): B = 0.006, p < 0.01, 10) with outdoor MET-Hrs (27–30 weeks): B = 0.006, p < 0.01, and 11) with recreation MET-HR (27–30 weeks): B = 0.006, p < 0.05. Lastly, women who gained less weight than recommended on average reported marginally greater beliefs in the influence of powerful others on the health of their fetus in comparison to women who gained weight within the recommended range (p = 0.09; data not shown).
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