Weight Gain Pattern during Pregnancy and Its Association with Delivery Fear and Cesarean Section Rate in Primiparous Women

Xiaoli CHAI; Li LI; Zhigang LIU; Wenyu YAN

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Xiaoli CHAI, Li LI, Zhigang LIU, Wenyu YAN. Weight Gain Pattern during Pregnancy and Its Association with Delivery Fear and Cesarean Section Rate in Primiparous Women[J]. Journal of Kunming Medical University.

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Xiaoli CHAI, Li LI, Zhigang LIU, Wenyu YAN. Weight Gain Pattern during Pregnancy and Its Association with Delivery Fear and Cesarean Section Rate in Primiparous Women[J]. Journal of Kunming Medical University.

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Weight Gain Pattern during Pregnancy and Its Association with Delivery Fear and Cesarean Section Rate in Primiparous Women

Department of Obstetrics，Pingliang Maternal and Child Health Hospital，Pingliang Gansu 744000，China

Received Date: 2025-07-18
Available Online: 2025-10-09

Abstract

Abstract

Objective To examine the association between gestational weight gain patterns and childbirth fear in primiparous women, as well as the mediating effect of childbirth fear on the connection between gestational weight gain patterns and cesarean section rates. Methods A total of 242 pregnant women who delivered in Pingliang Maternal and Child Health Hospital from March 2024 to March 2025 were selected as the study subjects. Latent growth mixed model （LGMM） was used to identify the gestational weight gain patterns of the subjects. Multivariate Logistic regression was employed to analyze the influencing factors of various pregnancy weight gain patterns. The cesarean section rates were compared across different weight gain patterns and levels of childbirth fear. Restricted cubic splines （RCS） were used to analyze the relationship between fear of childbirth score and cesarean section selection under different gestational weight gain patterns. A mediating effect model was applied to investigate the mediating effect of fear of childbirth on gestational weight gain patterns and cesarean section rate. The incidence of pregnancy complications and adverse pregnancy outcomes in women with different weight gain patterns was compared. A log-binominal model was used to estimate the association between gestational weight gain patterns and pregnancy complications. Results The LGMM model identified three patterns of gestational weight gain among the study subjects: Pattern I was characterized by mid-pregnancy accelerated weight gain （n = 60）; Pattern II was defined as a steady accelerated weight gain pattern （n = 98）; and Pattern III was identified as a late-pregnancy accelerated weight gain pattern （n = 84）. Multinomial logistic regression analysis indicated that, compared to Patterns I and II, higher pre-pregnancy BMI, younger age, higher childbirth fear scores, and lower pre-pregnancy exercise levels were more likely to lead to Pattern III weight gain （P < 0.05）. Among women with Pattern III weight gain, those with childbirth fear scores >39 exhibited the highest proportion of cesarean sections （36.90%）. RCS curve analysis revealed a significant positive correlation between childbirth fear scores and cesarean section rates across the three gestational weight gain patterns. The mediation effect model demonstrated that childbirth fear played a partial mediating role between gestational weight gain patterns and cesarean section rates, with the mediation effect accounting for 48.72% of the total effect. Women with Pattern I weight gain experienced significantly fewer cases of gestational hypertension and gestational diabetes compared to those with Patterns II and III （P < 0.05）. The Log-binomial model indicated that gestational weight gain patterns consistently had a significant impact on pregnancy complications （P < 0.05）. Conclusion Under different growth patterns during pregnancy, the fear of childbirth scores were all positively correlated with the choice of cesarean section. For primiparous pregnant women with an accelerated weight gain pattern in the late pregnancy stage, their fear of childbirth scores were higher, suggesting that pregnant women in the late stage of pregnancy should pay attention to weight management.
- Pregnant women,
- Fear of childbirth,
- Weight,
- Cesarean section,
- Mediating effect

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References(22)

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