Examining demographic and psychosocial factors related to self-weighing behavior during pregnancy and postpartum periods

Abstract

Black childbearing individuals in the US experience a higher risk of postpartum weight retention (PPWR) compared to their White counterparts. Given that PPWR is related to adverse health outcomes, it is important to investigate predictors of weight-related health behaviors, such as self-weighing (i.e., using a scale at home). Regular self-weighing is an evidence-based weight management strategy, but there is minimal insight into sociodemographic factors related to frequency. The Postpartum Mothers Mobile Study (PMOMS) facilitated longitudinal ambulatory weight assessments to investigate racial inequities in PPWR. Our objective for the present study was to describe self-weighing behavior during and after pregnancy in the PMOMS cohort, as well as related demographic and psychosocial factors. Applying tree modeling and multiple regression, we examined self-weighing during and after pregnancy. Participants (N = 236) were 30.2 years old on average (SD = 4.7), with the majority being college-educated (53.8%, n = 127), earning at least $30,000 annually (61.4%, n = 145), and self-identifying as non-Hispanic White (NHW; 68.2%, n = 161). Adherence to regular self-weighing (at least once weekly) was highest among participants during pregnancy, with a considerable decline after giving birth. Low-income Black participants (earning < $30,000) were significantly less likely to reach a completion rate of ≥ 80% during pregnancy (AOR = 0.10) or the postpartum period (AOR = 0.16), compared to NHW participants earning at least $30,000 annually. Increases in perceived stress were associated with decreased odds of sustained self-weighing after delivery (AOR = 0.79). Future research should consider behavioral differences across demographic intersections, such as race and socioeconomic status, and the impact on efficacy of self-weighing.

Keywords: Body weight; Ecological momentary assessment; Postpartum weight retention; Pregnancy; Self-weighing; Treatment adherence.

Fig. 1

Flow chart illustrating how pregnancy (n = 230) and postpartum samples (n = 202) were selected for analyses from the PMOMS cohort. ^aOne participant self-weighed once between 0 and 14 days after giving birth and not at any other time. ^bThe pregnancy and postpartum samples are overlapping in that some participants may be included in only the pregnancy sample (n = 34), only the postpartum sample (n = 6), or both (n = 196). NHW: non-Hispanic White; PMOMS: Postpartum Mothers Mobile Study.