Influence of provider advice and maternal attitudes on weight change and physical activity during pregnancy and postpartum Public Deposited

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Last Modified
  • March 21, 2019
Creator
  • Ferrari, Renee Marie
    • Affiliation: Gillings School of Global Public Health, Department of Maternal and Child Health
Abstract
  • Overweight and obesity are becoming the norm for American women. The 1999-2002 National Health and Nutrition Examination Survey found that greater than half of women ages 20-39 are overweight (25%) or obese (29%), representing a dramatic increase in prevalence over the past several decades. Not surprisingly, Healthy People 2010 has designated a reduction in overweight and obesity as one of the ten Leading Health Indicators for women. Both gaining too much weight during pregnancy and the failure to lose that weight are believed to pose risks for continued overweight/obesity over the course of a woman's lifetime. Unfortunately, we know little about why women gain too much pregnancy weight and why they fail to lose it during the postpartum period. Using data from a longitudinal cohort study that followed women from pregnancy to one year postpartum, this dissertation explored possible influences on pregnancy weight gain and postpartum weight retention. Two papers focused on pregnancy: the first examined the association between maternal attitudes about pregnancy weight gain and gestational weight gain adequacy, while the second explored whether provider advice in pregnancy is associated with adequacy. The third paper focus on the postpartum period and aimed both to characterize postpartum provider advice about weight loss and physical activity and to examine the association of such advice with weight retention and physical activity levels at 3 months postpartum. Results suggest that weight gain and postpartum weight retention are intransigent problems that show little change by attitude or advice; that measurement of attitudes and advice needs to be improved if we are to better understand their influence on weight gain and weight retention; that women are not receiving or not hearing provider advice; and that advice alone may not be enough to help women gain a healthy pregnancy weight and lose that weight in a timely fashion. This dissertation contributes to the body of knowledge about pregnancy weight gain and postpartum weight retention and holds implications for future interventions aimed at lowering excessive gestational weight gain, postpartum weight retention, and rates of overweight and obesity in reproductive-aged women.
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  • In Copyright
Advisor
  • Siega-Riz, Anna Maria
  • Melvin, Cathy L.
Degree granting institution
  • University of North Carolina at Chapel Hill
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  • Open access
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