Motivation for Maternal Healthy Lifestyle Behaviors-Implications for the Perinatal Period

Background: Healthy lifestyle behaviors are critical to maternal cardiometabolic health. Yet little research examines whether motivations for these behaviors shift from pregnancy—considered a time of strong motivation for self-care—to postpartum, often a vulnerable period marked by weight retention and barriers to self-care. Methods: We prospectively examined intrinsic motivation from early pregnancy to 1-year postpartum for 3 key behaviors: self-monitoring of weight (i.e., self-weighing, a standard weight management technique); healthy eating; and physical activity (PA) in the Pregnancy, Lifestyle and Environment Study-2 (PETALS-2). Diverse participants (N=167; 20% Asian, 7% Black, 27% Hispanic, 17% multiracial, 30% White) completed validated surveys at 10-13 weeks’ gestation and 1-year postpartum; higher scores on 5-point scales indicated greater motivation. Results: Overall, motivation for self-weighing was similarly low in pregnancy as postpartum (mean [SD] = 2.53 [0.84] vs. 2.42 [0.84]; p=.16). Motivation for healthy eating was descriptively higher, but with a non-significant trend toward decline over time (3.93 [0.66] vs. 3.83 [0.83]; p=.06). Motivation for PA was moderate and stable (3.32 [1.08] vs. 3.35 [1.03]; p=0.66). In regression analyses adjusted for education, race/ethnicity, pre-pregnancy BMI, and parity, motivation for PA declined significantly more over time among older vs. younger participants (40-44 vs. 18-24 years of age; score difference [95% CI]: -1.16 [-1.99, -0.32], p=.007). Conclusions: Intrinsic motivation for key lifestyle behaviors was generally stable from early pregnancy to 1-year postpartum, although older age was linked to decline in motivation for PA over time. Interventions to improve cardiometabolic health could capitalize on comparatively high motivation for healthy eating, while mitigating consistently low motivation for self-weighing and declining motivation for PA among older individuals in the perinatal period. Disclosure S.D.Brown: None. M.M.Hedderson: None. A.Millman: None. S.Daredia: None. H.Serrato bandera: None. C.Quesenberry: None. A.Ferrara: None. Funding National Institutes of Health (R01HL142996)