Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Doctor of Philosophy


Family Medicine


Stewart, Moira



The amount of weight that women gain during pregnancy has an impact on their health and the health of their babies. However, most women experience gestational weight gain in excess of the recommended amounts.


To gain a deeper understanding of women’s perspectives regarding gestational weight gain, to examine how they experience the advice that they receive pertaining to gestational weight gain, and to explore the association between gestational weight gain and their child’s weight status.


Three studies of different research designs were conducted. The first was a systematic review of qualitative, quantitative, and mixed methods studies to gain a broad understanding of pregnant women’s perceptions of gestational weight gain. This was followed by a qualitative study to explore the experience of women living in an urban area in Nova Scotia pertaining to the gestational weight gain advice that they receive. The third study used a retrospective cohort design to examine the association between gestational weight gain and offspring weight status.


Although pregnant women realized that gestational weight gain played a role in the health of their unborn child, which was their top priority, they were not certain about how much weight they should gain, partly because they did not report receiving much gestational weight-related advice from their prenatal care providers. Many women gained excess weight during pregnancy, which was associated with a higher body mass index trajectory observed in their children from birth to approximately five years of age.


Based on their perceptions of gestational weight gain and their experience of the gestational weight gain-related advice that they receive from their prenatal care providers, pregnant women reported that they could benefit from having more explicit and focused discussions pertaining to gestational weight gain with these providers. Such an approach could have downstream weight-related implications for their children and perhaps help to curb the childhood obesity epidemic.

Summary for Lay Audience

There are guidelines for how much weight women should gain during their pregnancies, and weight gain that falls above or below those recommendations is associated with adverse outcomes for mothers and their children. This PhD thesis aimed to first explore pregnant women’s perceptions of their pregnancy weight gain. Next, a qualitative study was undertaken locally, in Nova Scotia, to understand pregnant women’s experience of the advice that they received from a number of sources about their pregnancy weight gain. These studies showed that women’s top priority was the health of their baby. They were unsure about how much weight they should gain and they reported that their prenatal care providers did not often provide advice about weight gain.

Finally, a quantitative study was conducted to explore the relationship between pregnant women’s weight gain and the body mass index paths of their children from birth to approximately five years of age. This work showed that women who gained excess weight during pregnancy had children whose body mass index paths were significantly higher than children whose mothers had not gained excess pregnancy weight.