Abstract
Abstract Background. Excessive weight and obesity have progressively become a global epidemic and are consequently among the gravest health problems facing the world today. As the focus on the obesity epidemic has intensified, there has been an increasing recognition of pregnancy as a critical time for evaluating weight gain as a subsequent risk factor for obesity. Gestational weight is considered to be a promoting factor for the development of obesity in later life. Less is known about the women who are most likely to gain excessive weight during pregnancy. Given the negative maternal and child outcomes associated with higher gestational weight gain, there is a need to identify possible risk factors. Evidence suggests that eating problems may be a contributing factor. Studies have found eating problems to be associated with both weight gain and weight reduction in the general population. However, few studies have examined the influence of eating problems in relation to gestational weight gain. Thus, the main purpose of this study is to investigate to what extent self-reported symptoms of eating problems prior to pregnancy in addition to symptoms of eating problems during pregnancy are related to differences in total gestational weight gain. More specifically, exploring the relationships between pre-pregnancy dieting with binge-eating, ongoing symptoms of "binge-eating" and "dieting and restraint behaviors" alongside shape and weight-based self-esteem in the third trimester and gestational weight gain. Methods. The study is based on self- report data from a Norwegian cohort, the AHUS birth cohort study. The population consisted of approximately 2002 pregnant women. Data was collected at week 17 (T2) during pregnancy and week 32 (T2) during pregnancy, and 6 weeks (T3) postpartum. Multiple stepwise linear regression analysis was used to examine the relationships between eating problems and gestational weight gain, which of the independent variables contributed the most, and any significant (p< 0.05) predictors of this variant while adjusting for a variety of relevant covariates. Results. Mean gestational weight gain (GWG) for the entire sample was 14.33 kg. Women who reported pre-pregnancy dieting in addition to binge-eating and a shape and weight-based self-esteem in gestation week 32 gained significantly more weight than those with no symptoms present. A history of pre-pregnancy dieting with binge-eating and ongoing symptoms of dieting and restraint behaviors in gestation week 32 were not associated with GWG. Only binge-eating in gestation week 32 remained significantly associated with higher GWG after adjusting for significant covariates including pre-pregnancy BMI, parity, education, age. Women with a higher pre-pregnancy BMI had a lower risk of gaining higher GWG. Higher level of education and parity associated negatively with total GWG. Conclusion. Overall, binge-eating during the third trimester seems to be an important characteristic among women with a higher gestational weight gain in the sample. Further investigations should be conducted to strengthen our understanding of the relationship of eating problems to gestational weight gain and improve the counselling of pregnant women at risk. Identification of potentially modifiable risk factors such as binge-eating, provides opportunities for intervention studies to improve pregnancy outcomes and prevent maternal obesity.