RELATIONSHIP OF PSYCHOSOCIAL STATUS TO LOW PRENATAL WEIGHT-GAIN AMONGNONOBESE BLACK-AND-WHITE WOMEN DELIVERING AT TERM

Objective: To examine the association of six indices of psychosocial w ell-being with low prenatal weight gain. Methods: Scales assessing dep ression, trait anxiety, stress, mastery, self-esteem, and social suppo rt were self-administered at mid-pregnancy to 536 black and 270 while low-income, nonobese, multiparous women who subsequently delivered at term. All women had one or more risk factors for fetal growth restrict ion. The association of individual scale scores with prenatal weight g ain values below current institute of Medicine guidelines was examined while controlling for sociodemographic and reproductive variables, an d for time between last weight observation and delivery. Results: None of the scales were associated with low gain among black women. Among white women, poor scores (worst quartile) on four of the scales were a ssociated with increased adjusted odds ratios for low gain, including 2.5 for high trait anxiety, 3.0 for increased levels of depression, 3. 9 for low mastery, and 7.2 for low self-esteem. When scale scores and weight gain were examined as continuous variables, poor scores on five of the six scales were associated with lower weight gain values among white women (scores on the stress stale were the exception). Conclusi on: These data suggest an important role for psychosocial factors in t he etiology of low prenatal weight gain among white women but show no such role for black women. Along with reports of wide inter-individual variability in the energy costs of pregnancy, these data also suggest that attempts to manipulate pregnancy weight gain through dietary mea ns will meet with variable success until psychosocial and other factor s affecting prenatal energy intake and/or utilization are further deli neated.