1.1 Introduction
Pregnancy is a transformative period in a woman's life characterized by numerous physiological changes, including weight gain. Adequate weight gain during pregnancy is essential to support fetal growth and development, as well as to prepare the mother's body for childbirth and lactation. However, excessive or inadequate weight gain can pose risks to both maternal and fetal health, highlighting the importance of understanding the factors influencing weight gain during this crucial period. Weight gain patterns in pregnancy also vary according to gestational age. During the first trimester, weight gain is typically minimal, followed by a steady increase in the second and third trimesters. Factors such as maternal metabolism, appetite changes, and fetal growth influence weight gain trajectories at different stages of pregnancy.
According to Institute of Medicine (2009), one of the primary determinants of weight gain during pregnancy is the maternal pre-pregnancy Body Mass Index (BMI). Women with higher pre-pregnancy BMIs tend to gain less weight during pregnancy, while those with lower pre-pregnancy BMIs may gain more weight. According to the Institute of Medicine (IOM) guidelines, recommended weight gain ranges vary based on pre-pregnancy BMI categories (Institute of Medicine, 2009).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
Pregnancy is a dynamic physiological state characterized by significant changes in maternal body composition and metabolism to support fetal growth and development. Adequate weight gain during pregnancy is essential for ensuring optimal maternal and fetal health outcomes. However, both excessive and insufficient weight gain can contribute to adverse pregnancy complications, including gestational diabetes, hypertension, and macrosomia.
Several studies have highlighted the association between maternal weight gain during pregnancy and various health outcomes for both the mother and the offspring. For instance, excessive weight gain has been linked to an increased risk of gestational diabetes mellitus (GDM), preeclampsia, and cesarean delivery; whereas inadequate weight gain may lead to intrauterine growth restriction (IUGR) and low birth weight (Hauguel-de Mouzon & Shafrir, 2001).
Socioeconomic status (SES) plays a significant role in shaping dietary habits, access to healthcare, and lifestyle behaviors during pregnancy, all of which influence weight gain. Women from lower SES backgrounds may face barriers to accessing nutritious foods, prenatal care, and resources for physical activity, contributing to disparities in weight gain outcomes. Socioeconomic factors, including income, education, and access to healthcare, contribute significantly to variations in weight gain patterns during pregnancy. Women from marginalized communities or with lower socioeconomic status may face barriers to accessing nutritious foods, prenatal care, and resources for physical activity, leading to disparities in weight gain outcomes (Chung et al., 2018).
Cultural beliefs and practices surrounding pregnancy and dietary habits influence maternal weight gain trajectories. Cultural factors such as food preferences, traditional dietary practices, and beliefs about appropriate weight gain during pregnancy shape maternal dietary intake and may contribute to variations in weight gain patterns among different ethnic and cultural groups (Chasan-Taber et al., 2008). Access to prenatal care and healthcare services plays a crucial role in monitoring maternal weight gain and providing necessary interventions to optimize pregnancy outcomes. Women who receive regular prenatal care and counseling on nutrition and lifestyle behaviors are more likely to achieve appropriate weight gain during pregnancy and reduce the risk of complications (Laraia et al., 2005).
Understanding the complex interplay of biological, sociodemographic, cultural, and psychosocial factors influencing weight gain during pregnancy is essential for developing targeted interventions to promote optimal maternal and fetal health outcomes. Nutrition and physical activity behaviors profoundly impact maternal weight gain during pregnancy. A balanced diet rich in essential nutrients, coupled with regular physical activity, supports healthy weight gain and reduces the risk of complications such as gestational diabetes and hypertension. Conversely, poor dietary choices and sedentary lifestyles can lead to excessive weight gain and adverse pregnancy outcomes.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the factors influencing weight gain in pregnancy.
1.3 Statement of Problems
Investigation revealed that excessive weight gain during pregnancy is associated with various adverse maternal and fetal outcomes, including gestational diabetes, preeclampsia, macrosomia, and cesarean delivery (Nohr et al., 2008). Despite existing guidelines, many women exceed recommended weight gain ranges, highlighting the need for effective interventions to address this issue.
Conversely, inadequate weight gain during pregnancy increases the risk of intrauterine growth restriction (IUGR), low birth weight, and preterm birth (Siega-Riz et al., 2009). Certain maternal factors, such as socioeconomic disparities and inadequate access to healthcare, contribute to suboptimal weight gain outcomes.
Furthermore, the disparities in access to prenatal care and healthcare services affect monitoring of maternal weight gain and provision of interventions (Laraia et al., 2005). Improving access to prenatal care and integrating nutrition and lifestyle counseling into routine care can help address this challenge. Addressing these key challenges requires a comprehensive understanding of the multifaceted factors influencing weight gain during pregnancy and the development of tailored interventions to promote optimal maternal and fetal health outcomes.
1.4 Aim and Objectives of Study
The aim of the study is to comprehensively investigate the factors influencing weight gain during pregnancy and to develop targeted interventions to optimize maternal and fetal health outcomes. In achieving this aim, the following specific objectives were laid out as follows:
- To analyze disparities in access to prenatal care and healthcare services and their effect on monitoring maternal weight gain and providing interventions;
- To investigate cultural beliefs, dietary practices, and perceptions of ideal weight gain during pregnancy among different ethnic and cultural groups;
- To assess the impact of socioeconomic factors, including income, education, and access to healthcare, on maternal weight gain during pregnancy;
- To evaluate the role of psychosocial factors, such as stress, depression, and social support, in maternal weight gain behaviors during pregnancy;
- To assess the effectiveness of the developed interventions in promoting optimal weight gain and improving maternal and fetal health outcomes;
- To explore the influence of gestational age on maternal weight gain trajectories throughout pregnancy; and
- To provide recommendations for healthcare providers and policymakers to address disparities and promote healthy weight gain during pregnancy.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are the disparities in access to prenatal care and healthcare services and their effect on monitoring maternal weight gain and providing interventions?
- What are the cultural beliefs, dietary practices, and perceptions of ideal weight gain during pregnancy among different ethnic and cultural groups?
- What are the impact of socioeconomic factors, including income, education, and access to healthcare, on maternal weight gain during pregnancy?
- How effective is interventions in promoting optimal weight gain and improving maternal and fetal health outcomes?
- What is the influence of gestational age on maternal weight gain trajectories throughout pregnancy?
- What are the role of psychosocial factors, such as stress, depression, and social support, in maternal weight gain behaviors during pregnancy?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
- H01: Socioeconomic disparities contribute to variations in weight gain patterns during pregnancy, with women from lower socioeconomic backgrounds experiencing higher rates of excessive or inadequate weight gain.
- H02: Cultural beliefs and dietary practices influence maternal weight gain trajectories, leading to differences in weight gain patterns among different ethnic and cultural groups.
- H03: Access to prenatal care and healthcare services significantly influences maternal weight gain outcomes, with disparities in access contributing to suboptimal weight gain patterns.
- H04: Tailored interventions targeting modifiable factors, including nutrition education, lifestyle counseling, and support services, can positively impact maternal weight gain trajectories and improve pregnancy outcomes.
1.7 Significance of Study
The findings of this research will help identify and address disparities in weight gain outcomes among different demographic groups, including those based on socioeconomic status, ethnicity, and access to healthcare. By understanding the underlying determinants of these disparities, policymakers and healthcare providers can develop targeted interventions to reduce health inequities and improve health outcomes for all women and their infants.
Furthermore, it will inform healthcare policies and practices aimed at promoting healthy weight gain during pregnancy. By addressing socioeconomic disparities, improving access to prenatal care, and integrating nutrition and lifestyle counseling into routine care, healthcare systems can better support pregnant women in achieving optimal weight gain and reducing the burden of pregnancy-related complications.
Ultimately, this study will be of immense benefit to researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This research study on factors influencing weight gain in pregnancy contributes to knowledge and could serve as a guide for other study.
1.8 Scope of the Study
The scope of the research is focused on the factors influencing weight gain in pregnancy using Lagos State Primary Health Care (PHC) Centre as a case study.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Pre-pregnancy Body Mass Index (BMI):
It is a measure of body fat based on height and weight before pregnancy. It is calculated by dividing weight in kilograms by height in meters squared (Chu et al., 2007).
Gestational Weight Gain:
It is the total amount of weight gained by a pregnant woman from conception to delivery. It is typically categorized based on maternal pre-pregnancy BMI and gestational age (Institute of Medicine, 2009).
Socioeconomic Status (SES):
It is a measure of an individual's or family's economic and social position within society, often assessed based on income, education, occupation, and access to resources (Braveman et al., 2005).
Cultural Beliefs and Practices:
Beliefs, traditions, customs, and behaviors shared by members of a particular cultural or ethnic group, which may influence dietary habits, lifestyle behaviors, and perceptions of ideal weight gain during pregnancy (Chasan-Taber et al., 2008).
Psychosocial Factors:
Psychological and social factors that may influence maternal weight gain behaviors during pregnancy, including stress, depression, social support, and coping mechanisms (Herring et al., 2012).
Access to Prenatal Care:
It is the availability, affordability, and utilization of healthcare services during pregnancy, including prenatal visits, monitoring of maternal weight gain, and provision of interventions to optimize pregnancy outcomes (Laraia et al., 2005).
