Table 6.
Summary table of the relationship of cognitions related to dietary behavior to excess gestational weight gain in systematic review of psychological antecedents of excess gestational weight gain
| Author, year (Study reference number)* | Scale used**, Validation | Outcome(s) | Crude (unadjusted) results | Adjusted results | Confounders adjusted for | Summary of results |
|---|---|---|---|---|---|---|
| Exposure: Knowledge about nutrition | ||||||
| Wright 2013 [59] | Investigator developed, Validated | Excess GWG; | β (95% CI ): | Effect estimate not reported for excess GWG | Pre-Pregnancy BMI, age, race | Results were reported to be similar to secondary outcome but estimates were not reported. Hence considered NS on univariate or multivariate analyses |
| GWG (continuous)$$ | −1.2 (−3.2 to 0.69) | β (95% CI ) for secondary outcome: −0.14 (−2.8 to 2.5) | ||||
| Exposure: Weight concerns | ||||||
| Pomerleau 2000 [50] | Dieting and Binge Eating Severity Scale (DBESS), Validated | Difference between actual and current maximum recommended weight gain (continuous) | Mean (± SD) excess GWG between two weight concern categories: | Effect estimates not reported | NR | Significant on multivariate analysis; weight gain (lb) as a continuous outcome also has a positive significant association with weight concern categories ➔ |
| Low Weight Concern ;=2.9 (±12.7); | ANOVA F-test statistics = 7.614 (p <0.01) | |||||
| High Weight Concern 15.6 (±21.9) (p <0.01) | ||||||
| Cognitive dietary restraint | ||||||
| Conway 1999 [38] | Revised Restraint Scale (RRS), Validated | Excess GWG | Proportions with GWG categories (p-value): | NA | NA | NS on univariate analysis |
| Dietary Restraint (Full scale) 48%, 30% (p = 0.07); | Multivariate analysis was not done | |||||
| Weight Fluctuation subscale 46%, 31% (p = 0.054); | ||||||
| Concern for dieting subscale 50%, 33% (p = 0.601) | ||||||
| Laraia 2013 [43] | RRS, Validated | Excess GWG for univariate; | Proportion within GWG category: | β (95% CI ): | Pre-pregnancy BMI, maternal race, age, income, education, marital status, parity, gestational age, smoking, physical activity in 1st trimester | Full scale was significant on univariate or multivariate analyses; subscales were significant on multivariate analysis ➔ |
| Adequacy Ratio for univariate and multivariate | Low dietary Restraint Food secure 52.7%, 35.4%; | Interaction between Marginally Food Insecure and: | ||||
| Marginally food insecure 52.7%, 25.5% | High Restraint 0.53 (0.33 to 0.73) | |||||
| High dietary Restraint Food secure 71.5%, | Dieters 0.50 (0.30 to 0.70) | |||||
| 16.8%; | Weight Cyclers 0.54 (0.34 to 0.74) | |||||
| Marginally food insecure 74.0%, 11.0% | ||||||
| Overall х2(p-value ) :57.3 (p <0.001) | ||||||
| Mumford 2008 [48] | RRS, Validated | Adequacy Ratio | NR | OR (95% CI ): | Pre-pregnancy BMI, race, education, poverty, physical activity, weight gain attitude | Only subscales were significant on multivariate analyses ➔ |
| Overall | ||||||
| Restrained eating 1.12 (0.94 to 1.31) | ||||||
| Non-Restrained eating 0.95 (0.78 to 1.12) | ||||||
| Dieters vs. Non-Dieters | ||||||
| Underweight 0.94 (0.68 to 1.19); 1.02 (0.89 to 1.16); | ||||||
| Normal Weight 1.50 (1.40 to 1.60); 1.31 (1.23 to 1.40); Overweight 1.97 (1.80 to 2.15); 1.79 (1.54 to 2.03); | ||||||
| Obese 2.09 (1.98 to 2.21); 1.73 (1.53 to 1.93) | ||||||
| Cyclers vs. Non-Cyclers | ||||||
| Underweight 0.88 (0.66 to 1.11); 0.94 (0.77 to 1.11); | ||||||
| Normal Weight 1.38 (1.25 to 1.52); | ||||||
| 1.25 (1.12 to 1.37); Overweight 1.92 (1.72 to 2.12); 1.58 (1.35 to 1.80); | ||||||
| Obese 2.11 (1.96 to 2.26); 1.73 (1.54 to 1.91) | ||||||
| Exposure: Self-efficacy | ||||||
| McDonald 2013 [61] | Self-efficacy in achieving healthy weight, ii) towards controlling food Intake; iii) towards weight Management, not stated if validated | Excess GWG | OR (95% CI ): | NA | NA | NS on univariate Analysis; |
| 0.97 (0.92 to 1.02); ii) 0.91 (0.79 to 1.05); iii) 0.94 (0.86 to 1.03) | not entered in the multivariate model | |||||
| Olson 2003 [49] | Investigator Developed, Not validated | Excess GWG $$ | Effect estimate not reported (p-value NS) | NA | NA | NS on univariate analysis; variable not entered in the multivariate model |
| Wright 2013 [59] | Investigator developed, Not validated | Excess GWG; GWG (continuous)$$ | Effect estimate not reported for excess GWG | Effect estimate not reported for excess GWG | Pre-pregnancy BMI, age, race | Results were reported to be similar to secondary outcome but Estimates were not reported, hence considered significant on univariate or multivariate analysis 
|
| β (95% CI ) for secondary outcome: | β (95% CI ) for secondary outcome: −3.6 (−6.8 to −0.3) | |||||
| β (95% CI ) -1.3 (−2.6 – 0.0) | ||||||
| Exposure: Barriers to healthy eating | ||||||
| Wright 2013 [59] | Fowles’ Barriers to Health Eating Scale (BHES), Validated | Adequacy ratio; Excess GWG $$ | β (95% CI ): | β (95% CI ): | Pre-pregnancy BMI, age, race | Results were reported to be similar to secondary outcome but estimates were not reported, hence considered significant on multivariate analysis ➔ |
| 0.12 (−0.6 to 0.8) | 2.0 (0.3 to 3.7) | |||||
*Study reference number correspond to those cited in a pinwheel and web plot; **Scale details can be found in Additional file 1: Table S1; $2009 IOM GWG guidelines; $$ GWG measured in pounds (lb); ➔Positive association (Risk factor); 
Negative association (Protective factor); ANOVA: Analysis of Variance; BMI: Body Mass Index; GWG: Gestational Weight Gain; NA: Not Applicable; NS: Not Significant; RRS: Revised Restraint Scale.