The goal of this prospective cohort study is to investigate the contribution of stigma and discrimination due to body size to adverse pregnancy outcomes. We also aim to explore the role of psychological and social factors in this relationship. The specific objectives of this study are: Objective 1: Explore weight stigma as a mediator of the association between BMI ≥30 kg/m2 and adverse pregnancy outcomes. Objective 2: Explore confounding factors not previously considered such as weight cycling, trauma, eating disorders, and internalised weight bias as mediators in the relationship between obesity and adverse pregnancy outcomes.
The specific research questions for each objective are: Objective 1 RQ1.1: Does weight stigma experienced during pregnancy in a healthcare setting reported up to 34 weeks gestation mediate the association between pre-pregnancy obesity (BMI ≥30) and gestational diabetes mellitis (GDM) (primary outcome)? RQ1.2: Does weight stigma experienced during pregnancy in a healthcare setting reported up to 34 weeks gestation mediate the association between pre-pregnancy obesity (BMI ≥30) and (i) induction of labour; (iv) mode of birth; (ii) gestational hypertension (any); (iii) infant birth weight; and (iv) establishment of breastfeeding by 6 weeks postpartum (secondary outcomes)? Objective 2: RQ2.1: Do weight cycling, history of trauma, history of eating disorders, and internalised weight bias explain any of the variance in the mediation relationships described above?
Study Type
OBSERVATIONAL
Enrollment
800
Proportion of women diagnosed with gestational diabetes mellitis by 34 weeks gestation
Measuring the number of women reporting a diagnosis of gestational diabetes mellitis by 34 weeks gestation as assessed via self-reported measures and chart review.
Time frame: 34 weeks
Proportion of women experiencing induction of labour
Identifying whether the woman's labour was spontaneous or induced measured via a self-reported questionnaire.
Time frame: 6 weeks postpartum
Proportion of women reporting each mode of birth (i.e., vaginal birth, caesarean section, assisted vaginal birth, or other)
Identifying the mode of birth assessed via a self-reported questionnaire. Options are: vaginal birth, caesarean section, assisted vaginal birth (e.g., with forceps), or other.
Time frame: 6 weeks postpartum
Proportion of women who reported experiencing gestational hypertension in their most recent pregnancy
Identifying the proportion of women who reported a diagnosis of gestational hypertension during their most recent pregnancy via a self-reported questionnaire.
Time frame: 6 weeks postpartum
Infant birth weight (in grams) reported by mothers for their most recent infant
Infant birth weight (in grams) reported by mothers based on their most recent baby's birth certificate or hospital discharge summary information.
Time frame: 6 weeks postpartum
Proportion of women currently breastfeeding their infant reported by mothers at 6-weeks postpartum
The proportion of women currently breastfeeding their infant (yes/no) reported by mothers at 6-weeks postpartum
Time frame: 6 weeks postpartum
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