Determinant Factors in Excessive Gestational Weight Gain: Physical Activity, Nutritional Status, and Anxiety

This study aims to identify which of the following factors-physical activity level, nutritional status, or pregnancy-related anxiety-has the strongest influence on excessive gestational weight gain. Pregnant women in their third trimester who are being followed at Gebze Fatih State Hospital and meet the inclusion criteria will be referred to the Exercise Therapy Laboratory of the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakıf University. After being informed about the study and providing written informed consent, participants will undergo a face-to-face assessment. Data will be collected prospectively using a demographic information form, the Pregnancy Physical Activity Questionnaire (PPAQ), a nutritional status assessment form, and a pregnancy-related anxiety questionnaire.

Study Overview

• Status: Recruiting
• Conditions: Pregnancy; Excessive Gestational Weight Gain
• Intervention / Treatment: Other: None (Observational Study)

Detailed Description

Excessive gestational weight gain is a significant public health concern due to its association with adverse maternal and neonatal outcomes. Multiple factors, including lifestyle behaviors and psychological status, may contribute to excessive weight gain during pregnancy. However, the relative contribution of physical activity, nutritional status, and pregnancy-related anxiety remains unclear.

The primary objective of this prospective observational study is to comprehensively determine which of these variables-physical activity level, nutritional status, or pregnancy-related anxiety-has the most significant effect on excessive gestational weight gain.

The study population will consist of pregnant women in their third trimester who are being followed with a diagnosis of pregnancy at Gebze Fatih State Hospital and who meet the predefined inclusion criteria. Eligible participants will be referred to the Exercise Therapy Laboratory of the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakıf University.

After receiving detailed verbal and written information about the study, all participants will be asked to provide written informed consent prior to enrollment. Data collection will be conducted prospectively through face-to-face interviews.

Participants will complete the following assessment tools:

A demographic characteristics form, The Pregnancy Physical Activity Questionnaire (PPAQ) to assess physical activity levels, A nutritional status assessment form to evaluate dietary habits, A pregnancy-related anxiety questionnaire to assess anxiety levels associated with pregnancy.

The collected data will be analyzed to determine the relative impact of physical activity, nutritional status, and pregnancy-related anxiety on excessive gestational weight gain.

• Study Type: Observational
• Enrollment (Estimated): 150

Contacts and Locations

• Study Contact: Name: Ayşe Sena Manzak Dursun, PT, PhD; Phone Number: +0905356735150; Email: amanzak@bezmialem.edu.tr

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Recruiting
    • Bezmialem Vakıf University
    • Contact: Ayşe Sena Manzak Dursun, PT, PhD, Asisstant Prof.; Phone Number: +905356735150; Email: amanzak@bezmialem.edu.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Pregnant women in the third trimester attending antenatal care clinics will be evaluated once and classified according to IOM-based gestational weight gain categories.

Description

Inclusion Criteria:

• Being in the 3rd trimester of pregnancy
• Being between 18 and 45 years old
• Having the intellectual capacity to understand and respond to what is read.

Exclusion Criteria:

• High-risk pregnancy
• Multiple pregnancy
• Having a chronic disease such as a systemic, neurological, orthopedic, etc.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Excessive GWG; Participants will be assessed once in the third trimester and categorized into excessive and non-excessive gestational weight gain groups based on IOM recommendations. Physical activity, dietary intake, and pregnancy-related anxiety will be assessed concurrently.	Other: None (Observational Study); This is an observational study. No intervention is assigned to participants. All assessments are conducted as part of routine data collection without any experimental or behavioral intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants with Excessive Gestational Weight Gain	Gestational weight gain classified as excessive or non-excessive according to the Institute of Medicine (IOM) recommendations adjusted for pre-pregnancy body mass index.	Single assessment during the third trimester (28-40 weeks of gestation)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical Activity Level (MET-hours per week)	hysical activity is assessed using the Pregnancy Physical Activity Questionnaire (PPAQ). The questionnaire includes 32 items covering household/care activities, occupational activities, and sports/exercise. Time spent in each activity is multiplied by standardized metabolic equivalent (MET) values to calculate energy expenditure, expressed as MET-hours per week (MET-h/week). Activities are classified by intensity as sedentary (<1.5 METs), light (1.5-3.0 METs), moderate (3.0-6.0 METs), or vigorous (>6.0 METs). Higher MET-hours per week indicate higher levels of physical activity (better outcome).	Single assessment during the third trimester (28-40 weeks of gestation)
Daily Energy Intake (kcal/day)	Dietary intake is assessed using a 24-hour dietary recall form. Total daily energy intake is calculated in kilocalories per day (kcal/day). Higher values indicate higher daily energy intake.	Single assessment during the third trimester (28-40 weeks of gestation)
Pregnancy-Related Anxiety Score	Pregnancy-related anxiety is assessed using the Pregnancy-Related Anxiety Scale. The scale consists of 33 items rated on a 4-point Likert scale and includes 9 subscales. Eleven items are reverse-coded. Total scores range from 33 to 132, with higher scores indicating higher levels of pregnancy-related anxiety (worse outcome). The scale has no established cut-off value and can be applied to both primiparous and multiparous pregnant women.	Single assessment during the third trimester (28-40 weeks of gestation)

Collaborators and Investigators

• Sponsor: Bezmialem Vakif University

Study record dates

Study Major Dates

• Study Start (Actual): January 2, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): August 1, 2026

Study Registration Dates

• First Submitted: January 13, 2026
• First Submitted That Met QC Criteria: January 21, 2026
• First Posted (Actual): January 26, 2026

Study Record Updates

• Last Update Posted (Actual): February 19, 2026
• Last Update Submitted That Met QC Criteria: February 17, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: physical activity; nutritional status; anxiety
• Additional Relevant MeSH Terms: Mental Disorders; Behavior; Anxiety Disorders; Motor Activity; Investigative Techniques; Methods; Observation
• Other Study ID Numbers: 2025/493

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No