Towards an understanding of pregnancy weight gain in African-American women

Abstract

<p><strong>Problem:</strong> A large proportion of women gain more weight than is needed during pregnancy. This is a major health issue because excessive gestational weight gain contributes to postpartum weight retention, which contributes to long term obesity in women and their offspring. African-American women in particular have high rates of obesity with half (49.6%) classified as obese and 14.2% as grade 3 obesity (BMI&gt;=40kg/m2).</p> <p><strong>Theoretical base:</strong> A common construct across multiple behavior change theories, including social cognitive theory, is that behavior change is impacted by personal factors including risk appraisal and motivation to change.</p> <p><strong>Purpose:</strong> In order to determine the perspective of pregnant African-American women on weight gain in pregnancy we conducted formative work to elicit these antecedents to behavior change.</p> <p><strong>Method:</strong> Focus groups were conducted using rigorous approaches (e.g., trained moderator, standardized interview guide, taped transcripts analyzed verbatim) with 26 impoverished African-American women (age range 18-39 years).</p> <p><strong>Results:</strong> Between- and within- group analyses identified four themes: (a) Weight gain, no matter how much, means a healthy baby, (b) There is a limit: Weight gain impact on appearance, (c) Reluctant acceptance: It happens, and (d) Nebulous plans for controlling weight. These women clearly identified the need for weight gain to ensure a healthy baby. However, there was a great tolerance with amount of weight they could gain before it became unacceptable. Although they identified a few strategies for controlling weight (e.g. reducing fried foods), most women were unenthusiastic and half-hearted about controlling gestational weight gain.</p> <p><strong>Conclusions/Implications:</strong> The negative impact of excessive pregnancy weight gain on the infant was not identified. Intolerance of weight gain was almost exclusively due to appearance; it was never related to health risks. Understanding women's appraisal of risk and motivation to address excessive weight gain in pregnancy is key to successful intervention development tailored for this population.</p>