Effects of Maternal Pre-pregnancy Body Mass Index and Gestational Weight Gain on Antenatal Mental Disorders in China: a Prospective Study

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2023 Mar 19

PMID 36934260

Authors

Xuan Zhou

Lin Rao

Dongjian Yang

Tong Wang

Hong Li

Zhiwei Liu

Affiliations

Soon will be listed here.

Abstract

Background: Maternal obesity is the most common medical condition among women of reproductive age worldwide. The pre-pregnancy body mass index and gestational weight gain have been suggested to be associated with maternal mental disorders. This study aimed to investigate the effects of the pre-pregnancy body mass index and gestational weight gain on antenatal depression, stress, and anxiety.

Methods: In total, 4,890 pregnant women were enrolled in the present study, which is based on an ongoing prospective cohort study. We used self-reported pre-pregnancy weights and the last weights measured prior to delivery (using professional instruments) to calculate the pre-pregnancy body mass index and gestational weight gain. The questionnaires used included the Center for Epidemiologic Studies Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and 10-item version of the Perceived Stress Scale (PSS-10). We used Pearson product-moment correlation and multivariable logistic regression models to examine the impact of the pre-pregnancy body mass index and gestational weight gain on different maternal mental disorders.

Results: After adjusting for conception, annual household income, occupation, education, smoking status, and drinking status, excessive gestational weight gain during pregnancy was associated with a greater chance of anxiety symptoms in the entire sample (adjusted model: odds ratio = 1.479, 95% confidence interval = 1.128, 1.938) and especially in women with a normal body mass index (adjusted model: odds ratio = 1.668, 95% confidence interval = 1.209, 2.302). However, the relationship between the maternal pre-pregnancy body mass index and mental health was not significant.

Conclusion: Pregnant women with a normal pre-pregnancy body mass index had a greater chance of experiencing anxiety symptoms before delivery if gestational weight gain was excessive; however, its effects on depression or stress symptoms were not observed. The maternal pre-pregnancy body mass index may not be independently associated with maternal mental disorders.

Citing Articles

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Roddy Mitchell A, Gordon H, Atkinson J, Lindquist A, Walker S, Middleton A JAMA Netw Open. 2023; 6(11):e2343711.

PMID: 37976063 PMC: 10656650. DOI: 10.1001/jamanetworkopen.2023.43711.

References

Zanardo V, Giliberti L, Giliberti E, Grassi A, Perin V, Parotto M . The role of gestational weight gain disorders in symptoms of maternal postpartum depression. Int J Gynaecol Obstet. 2020; 153(2):234-238. DOI: 10.1002/ijgo.13445. View

Montagnoli C, Zanconato G, Cinelli G, Tozzi A, Bovo C, Bortolus R . Maternal mental health and reproductive outcomes: a scoping review of the current literature. Arch Gynecol Obstet. 2020; 302(4):801-819. DOI: 10.1007/s00404-020-05685-1. View

Dindo L, Elmore A, OHara M, Stuart S . The comorbidity of Axis I disorders in depressed pregnant women. Arch Womens Ment Health. 2017; 20(6):757-764. PMC: 5759963. DOI: 10.1007/s00737-017-0769-y. View

Vinturache A, Winn A, Mannion C, Tough S . Women's recall of health care provider counselling on gestational weight gain (GWG): a prospective, population-based study. BMC Pregnancy Childbirth. 2019; 19(1):136. PMC: 6485057. DOI: 10.1186/s12884-019-2283-x. View

Razurel C, Kaiser B, Antonietti J, Epiney M, Sellenet C . Relationship between perceived perinatal stress and depressive symptoms, anxiety, and parental self-efficacy in primiparous mothers and the role of social support. Women Health. 2016; 57(2):154-172. DOI: 10.1080/03630242.2016.1157125. View

Withers M, Kharazmi N, Lim E . Traditional beliefs and practices in pregnancy, childbirth and postpartum: A review of the evidence from Asian countries. Midwifery. 2017; 56:158-170. DOI: 10.1016/j.midw.2017.10.019. View

Walter S, Mejia-Guevara I, Estrada K, Liu S, Glymour M . Association of a Genetic Risk Score With Body Mass Index Across Different Birth Cohorts. JAMA. 2016; 316(1):63-9. DOI: 10.1001/jama.2016.8729. View

Cheng C, Chou Y, Chang C, Liou S . Trends of Perinatal Stress, Anxiety, and Depression and Their Prediction on Postpartum Depression. Int J Environ Res Public Health. 2021; 18(17). PMC: 8431252. DOI: 10.3390/ijerph18179307. View

Zhou B . Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci. 2002; 15(1):83-96. View

10.

Dennis C, Falah-Hassani K, Shiri R . Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017; 210(5):315-323. DOI: 10.1192/bjp.bp.116.187179. View

11.

Naaz N, Mehnaz S, Ansari M, Amir A . Maternal mental health and its determinants - A community-based cross-sectional study in Aligarh, Uttar Pradesh. Indian J Public Health. 2021; 65(1):16-21. DOI: 10.4103/ijph.IJPH_193_20. View

12.

McCarthy M, Houghton C, Matvienko-Sikar K . Women's experiences and perceptions of anxiety and stress during the perinatal period: a systematic review and qualitative evidence synthesis. BMC Pregnancy Childbirth. 2021; 21(1):811. PMC: 8647378. DOI: 10.1186/s12884-021-04271-w. View

13.

Silveira M, Ertel K, Dole N, Chasan-Taber L . The role of body image in prenatal and postpartum depression: a critical review of the literature. Arch Womens Ment Health. 2015; 18(3):409-21. PMC: 4810003. DOI: 10.1007/s00737-015-0525-0. View

14.

Eichler J, Schmidt R, Hiemisch A, Kiess W, Hilbert A . Gestational weight gain, physical activity, sleep problems, substance use, and food intake as proximal risk factors of stress and depressive symptoms during pregnancy. BMC Pregnancy Childbirth. 2019; 19(1):175. PMC: 6525385. DOI: 10.1186/s12884-019-2328-1. View

15.

Mao Q, Zhu L, Su X . A comparison of postnatal depression and related factors between Chinese new mothers and fathers. J Clin Nurs. 2011; 20(5-6):645-52. DOI: 10.1111/j.1365-2702.2010.03542.x. View

16.

Kominiarek M, Grobman W, Adam E, Buss C, Culhane J, Entringer S . Stress during pregnancy and gestational weight gain. J Perinatol. 2018; 38(5):462-467. PMC: 5999529. DOI: 10.1038/s41372-018-0051-9. View

17.

Bodnar L, Wisner K, Moses-Kolko E, Sit D, Hanusa B . Prepregnancy body mass index, gestational weight gain, and the likelihood of major depressive disorder during pregnancy. J Clin Psychiatry. 2009; 70(9):1290-6. PMC: 2760651. DOI: 10.4088/JCP.08m04651. View

18.

Hartley E, McPhie S, Skouteris H, Fuller-Tyszkiewicz M, Hill B . Psychosocial risk factors for excessive gestational weight gain: A systematic review. Women Birth. 2015; 28(4):e99-e109. DOI: 10.1016/j.wombi.2015.04.004. View

19.

Shoraka H, Amirkafi A, Garrusi B . Review of Body Image and some of Contributing Factors in Iranian Population. Int J Prev Med. 2019; 10:19. PMC: 6390429. DOI: 10.4103/ijpvm.IJPVM_293_18. View

20.

Braig S, Logan C, Reister F, Rothenbacher D, Genuneit J . Psychosocial stress and longitudinally measured gestational weight gain throughout pregnancy: The Ulm SPATZ Health Study. Sci Rep. 2020; 10(1):1996. PMC: 7005281. DOI: 10.1038/s41598-020-58808-8. View