Development and Psychometric Validation of the Pregnancy-related Weight Stigma Scale among Pregnant Women in Nigeria

Abstract Background: Exposure to weight stigma during pregnancy has been linked to numerous adverse outcomes. However, efforts to accurately assess and address pregnancy-related weight stigma are complicated by the lack of a validated, pregnancy-specific measurement tool. Objectives: This study aimed to develop and evaluate the factor structure and internal consistency of the Pregnancy-Related Weight Stigma Scale (PRWSS) for measuring weight stigma among pregnant women attending an antenatal clinic at a health facility in Enugu state, Nigeria. Materials and Methods: The study employed a cross-sectional descriptive design with a sample of 197 pregnant women recruited via simple random sampling at a health facility in Enugu Metropolis, and 194 responses were gotten. The PRWSS was originally developed as a 10-item instrument and subsequently revised to a 9-item scale following two rounds of expert review. The content validity indices for both versions were 0.92 and 1, respectively. Results: The PRWSS showed good reliability (Cronbach’s alpha = 0.794). Tests confirmed the data suited factor analysis (Bartlett’s test: χ 2 = 632, df = 36, P < 0.001; Kaiser–Meyer–Olkin = 0.803). Exploratory factor analysis revealed a 3-factor model with factors 1, 2, and 3 having eigenvalues of 3.817, 1.357, and 1.018, respectively, indicating that the scale is multidimensional in nature. Conclusion: The PRWSS demonstrates reliability and validity as a tool for measuring pregnancy-specific weight stigma. Data derived from the PRWSS can facilitate efforts to address weight-related stigma, including the psychological and social burdens, which remain underexplored within maternal health care in resource-constrained settings like Nigeria.