Association of nutritional and psychosocial factors with early gestational weight gain
Notice bibliographique
Résumé
Background: Maternal compliance with gestational weight gain (GWG) guidelines is poor; approximately 20% of women have inadequate weight gain and because 50% gain excessively, pregnancy is now considered obesogenic. Even though multiple factors influence GWG, psychosocial and behavioural factors have not been studied. Methodology: Three studies were designed to assess: 1) evidence for early maternal perinatal counseling; 2) compliance with, and determinants of, Eating Well with Canada's Food Guide (CFG); and 3) sociodemographic, biomedical, psychosocial, and behavioural determinants of inadequate and excessive GWG in the first trimester. A total of 594 women (mean age = 33.0 ± 4.4 years) were recruited at 14.2 ± 1.4 wks. Online validated questionnaires assessed psychosocial factors (e.g. depression, stress, emotional eating, mindfulness, attitudes/barriers, and self-efficacy) and behavioural factors (e.g. diet, physical activity, and sleep). GWG was calculated and standardized using: [(weight at recruitment – pre-pregnancy weight)/gestational weeks] x 14.0]. A hierarchical multivariate statistical regression analysis was used to identify determinants of adherence to CFG and of inadequate and excessive GWG. Results: Women did not receive preconception counseling about vitamin use (43%), tobacco use (71%), alcohol consumption (69%), physical activity (77%), or being a healthy weight (79%). Only 26% received GWG counseling. Overall adherence to CFG was poor: <15% met the recommended servings of vegetables and fruit (13.6%) and grain products (14.9%). Results from the hierarchical regression model identified age, attitudes towards healthful eating, snacking, and nutrition self-efficacy as predictive of greater adherence to CFG; immigration status, pregnancy intention, and barriers to healthful eating were associated with lesser adherence to CFG.The prevalence of excessive GWG during the first trimester (>2.0 kg) was 50.8% (n=206); appropriate GWG (0.5kg ≤ GWG ≥ 2.0kg) was 26.2% (n=106); and inadequate GWG (<0.5kg) was 23.0% (n=93). Greater depressive symptoms were associated with an increased likelihood of inadequate (OR: 2.38; p=0.03) and excessive GWG (OR: 2.32; p=0.01). In contrast, improved dietary quality was associated with a decreased likelihood of inadequate (OR: 0.82; p=0.04) and excessive GWG (OR: 0.82; p=0.01). Moreover, greater mindfulness (OR: 2.22; p<0.001), increased BMI (OR: 1.72; p=0.02), and poor sleep quality (OR: 1.16; p=0.02) were associated with an increased likelihood of inadequate GWG whereas increased household physical activity (OR: 0.99; p=0.01) decreased the likelihood. Interestingly, a higher planned GWG (OR: 1.21; p<0.001) and greater nutritional self-efficacy (OR: 1.12; p=0.01) increased the odds of excessive GWG.Implications: Maternal depression screening and nutrition counseling in early pregnancy, combined with tailored interventions, may improve GWG compliance given the interplay among GWG determinants.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».