Antenatal weighing and gestational weight gain

Research output: ThesisDoctoral Thesis


Background: There is no clear guidance on how best to support women to achieve healthy gestational weight gain. The dominant physiological approach of energy in / energy out for weight management, such as diet and exercise interventions, has demonstrated moderate effectiveness at best for optimising gestational weight gain. Increasingly, routine antenatal weighing is being used to monitor women against gestational weight gain targets. However, to optimise pregnancy weight gain, broader socio-ecological approaches to physical and mental health in pregnancy are required.
Objectives: The primary objectives of this thesis are twofold; 1) To investigate the effectiveness of antenatal weight-monitoring as a health promotion strategy for optimising pregnancy weight gain; and 2) To explore the psychosocial factors associated with weight gain in pregnancy.
Methods: A thesis by publication inclusive of a series of six distinct but complementary publications, using a variety of research designs and methodologies were devised to address specific research aims as follows. Aim 1: Perform a systematic review of the literature to ascertain the effectiveness of routine antenatal weighing as a stand-alone intervention to reduce excessive pregnancy weight gain. Aim 2: Conduct a narrative review and evidence synthesise in response to the Australian Department of Health, Pregnancy Care Guidelines, recommending the re-introduction of routine antenatal weighing. Aim 3: Perform a revalidation of the Weight-Related Behaviours Questionnaire, originally designed and tested in a pregnancy cohort in the United States, within an Australian pregnancy cohort. Aim 4: Identify and describe the demographic and psychosocial factors predictive of excessive gestational weight gain, within an Australian pregnancy cohort. Aim 5: Develop a short-form, psychosocial assessment tool for the detection of women at risk of excessive gestational weight gain. Aim 6: Perform a qualitative analysis of the experience and perspectives of pregnant women who participated in a pilot weight management randomised controlled trial. Conclusion: Overall, this program of work concludes existing evidence does not support weight-monitoring as a weight management strategy, with effects on maternal psychology largely unknown. To optimise gestational weight gain, broad socio-ecological approaches to health promotion are required, considering factors like self-efficacy and body image during antenatal care.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • University of Newcastle
  • Hure, Alexis J., Principal Supervisor, External person
  • Attia, John, Co-Supervisor, External person
  • Foureur, Maralyn, Co-Supervisor, External person
  • Hazelton, Michael, Co-Supervisor
Award date21 Jul 2021
Place of PublicationNewcastle, NSW
Publication statusPublished - 20 Jun 2022


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