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Moffat T, McKerracher L, Oresnik S, Atkinson SA, Barker M, McDonald SD, Murray-Davis B, Sloboda DM. Investigating the normalization and normative views of gestational weight gain: Balancing recommendations with the promotion and support of healthy pregnancy diets. Am J Hum Biol 2021; 33:e23604. [PMID: 33956376 DOI: 10.1002/ajhb.23604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/23/2021] [Accepted: 03/24/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Gestational weight gain (GWG) is increasingly monitored in the United States and Canada. While promoting healthy GWG offers benefits, there may be costs with over-surveillance. We aimed to explore these costs/benefits. METHODS Quantitative data from 350 pregnant survey respondents and qualitative focus group data from 43 pregnant/post-partum and care-provider participants were collected in the Mothers to Babies (M2B) study in Hamilton, Canada. We report descriptive statistics and discussion themes on GWG trajectories, advice, knowledge, perceptions, and pregnancy diet. Relationships between GWG monitoring/normalization and worry, knowledge, diet quality, and sociodemographics-namely low-income and racialization-were assessed using χ2 tests and a linear regression model and contextualized with focus group data. RESULTS Most survey respondents reported GWG outside recommended ranges but rejected the mid-20th century cultural norm of "eating for two"; many worried about gaining excessively. Conversely, respondents living in very low-income households were more likely to be gaining less than recommended GWG and to worry about gaining too little. A majority had received advice about GWG, yet half were unable to identify the range recommended for their prepregnancy BMI. This proportion was even lower for racialized respondents. Pregnancy diet quality was associated with household income, but not with receipt or understanding of GWG guidance. Care-providers encouraged normalized GWG, while worrying about the consequences of pathologizing "abnormal" GWG. CONCLUSIONS Translation of GWG recommendations should be done with a critical understanding of GWG biological normalcy. Supportive GWG monitoring and counseling should consider clinical, socioeconomic, and community contexts.
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Affiliation(s)
- Tina Moffat
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada
| | - Luseadra McKerracher
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Oresnik
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada
| | | | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sarah D McDonald
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada.,Departments of Radiology and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Maternal-Fetal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Beth Murray-Davis
- McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Deborah M Sloboda
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.,Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada.,Farncombe Family Digestive Diseases Research Institute, McMaster University, Hamilton, Ontario, Canada
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