Mental health after childbirth and the impact on postpartum weight retention and body composition. Data from the INTER‐ACT randomized controlled trial

Uytsel, Hanne Van; Ameye, Lieveke; Devlieger, Roland; Bijlholt, Margriet; Jacquemyn, Yves; Catry, Vincent; Schreurs, Annick; Bogaerts, Annick

doi:10.1111/cob.12550

Cited by 4 publications

(8 citation statements)

References 42 publications

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“… 34 These potential explanations should be further explored in qualitative research, but our results do suggest that mHealth interventions may be less interesting to reach women with prior mental health struggles. Considering the link between mental health struggles and PPWR 12 it would be beneficial to co-design future interventions together with this target group to ensure that the intervention meets their needs.…”

Section: Discussionmentioning

confidence: 99%

“…Women with excessive gestational weight gain are vulnerable to mental health issues, and this in turn has been shown to increase PPWR and related body composition measures. 12 However, there is little understanding of the role self-monitoring of mental health may have on reducing PPWR. Therefore, we question to what extent more intensive self-monitoring of emotional status and stress levels through the app increases postpartum weight loss (Research Question [RQ] 1) and reduces substantial PPWR (RQ2).…”

Section: Introductionmentioning

confidence: 99%

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The impact of self-monitoring physical and mental health via an mHealth application on postpartum weight retention: Data from the INTER-ACT RCT

Geusens,

Van Uytsel,

Ameye

et al. 2024

Health Promot Perspect

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Background: Postpartum weight retention (PPWR) has many health risks. Digital self-monitoring of weight can potentially make postpartum weight management easier. We aim to test to what extent the self-monitoring of weight, steps and mental health through an mHealth application increases postpartum weight loss and reduces the odds of substantial PPWR (≥5 kg). Methods: Participants were mothers in the intervention arm of the INTER-ACT multicenter randomized controlled trial (RCT), an inter-pregnancy lifestyle intervention among mothers with excessive gestational weight gain. Participants (n=288) had access to an mHealth application to log their weight, steps and mental health between 6 weeks and 6 months postpartum. A linear multiple regression model and a logistic regression model were run to test to what extent self-monitoring via the app increases postpartum weight loss and reduces the risk of substantial PPWR. Results: Women who logged their weight more often lost more weight (B=0.03, β=0.26, CIB =[0.01,0 .05], P<0.01), and had reduced odds of substantive PPWR (OR=0.99, CIOR =[0.98, 0.999], P<.05). Mental health logging reduced the odds of substantive PPWR (OR=0.98, CIOR =[0.97, 1.00], P<0.05), but was unrelated to the amount of weight loss. Steps logging was unrelated to either weight loss or substantive PPWR. Conclusion: Mothers with excessive gestational weight gain can benefit from app-based lifestyle interventions to reduce PPWR by self-monitoring their weight. More attention to mental health in PPWR interventions is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of self-monitoring physical and mental health via an mHealth application on postpartum weight retention: Data from the INTER-ACT RCT

Geusens,

Van Uytsel,

Ameye

et al. 2024

Health Promot Perspect

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“…The primary aim of the study was to assess the effectiveness of the INTER-ACT intervention on pregnancy and birth-related complications (a composite outcome: gestational diabetes, pregnancy-induced hypertension, cesarean section and large-gestational-age babies) in the subsequent pregnancy. Secondary outcomes (postpartum maternal mental health, postpartum weight retention and body composition and postpartum lifestyle behaviors such as eating behavior and physical activity) have already been analyzed [ 25 , 26 , 27 , 28 , 29 ]. The current secondary analyses focus on maternal mental health, pre-pregnancy weight and body composition during the interpregnancy period.…”

Section: Methodsmentioning

confidence: 99%

Mental Health during the Interpregnancy Period and the Association with Pre-Pregnancy Body Mass Index and Body Composition: Data from the INTER-ACT Randomized Controlled Trial

et al. 2023

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Mental health problems and obesity are two common complications during pregnancy and postpartum. The preconception period is considered an appropriate period for prevention. Therefore, insights into interpregnancy mental health and the impact on weight and body composition are of interest to developing effective weight management strategies. The primary aim of this study is to assess the difference in women’s mental health during the interpregnancy period and the association with pre-pregnancy body mass index (BMI) and body composition. The secondary aim is to study whether this association is affected by socio-demographic factors, interpregnancy interval and sleep. The study is a secondary analysis of the INTER-ACT e-health-supported lifestyle trial. Women were eligible if they had a subsequent pregnancy and mental health measurements at 6 weeks after childbirth and at the start of the next pregnancy (n = 276). We used univariate analyses to assess differences in mental health and performed regression analysis to assess their association with pre-pregnancy BMI and body composition at the start of the next pregnancy. Our results show a statistically significant increase in anxiety and depressive symptoms between 6 weeks after childbirth and the start of the next pregnancy (sSTAI-6 ≥ 40: +13%, p =≤ 0.001; GMDS ≥ 13: +9%, p = 0.01). Of the women who were not anxious at 6 weeks after childbirth (sSTAI < 40), more than one-third (39%) developed anxiety at the start of the next pregnancy (p =≤ 0.001). Regression analysis showed that sense of coherence (SOC-13) at the start of the next pregnancy was independently associated with women’s pre-pregnancy BMI and fat percentage. We believe that the development of preconception lifestyle interventions that focus on both weight reduction and support in understanding, managing and giving meaning to stressful events (sense of coherence) may be of added value in optimizing women’s preconception health.

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“…The methodology of the mental health questionnaires was also described in previous research [24]. Characteristics of the mental health questionnaires are presented in Table 1.…”

Section: Data-collectionmentioning

confidence: 99%

“…Globally, 20% of women experience mental health problems in the first year after childbirth [1]. Almost half of women who had pre-existing excessive gestational weight gain (GWG) report mental problems 6 weeks after childbirth [2]. Poor mental health during the peripartum period can result in the development of chronic mental disorders in the long run, in both mother and child [3,4].…”

Section: Introductionmentioning

confidence: 99%

Effect of the INTER-ACT lifestyle intervention on maternal mental health during the first year after childbirth: A randomized controlled trial

et al. 2023

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We assess whether the INTER-ACT postpartum lifestyle intervention influences symptoms of depression and anxiety, sense of coherence and quality of life during the first year after childbirth. A total of 1047 women of the INTER-ACT RCT were randomized into the intervention (n = 542) or control arm (n = 505). The lifestyle intervention consisted of 4 face-to-face coaching sessions, supported by an e-health app. Anthropometric and mental health data were collected at baseline, end of intervention and 6-months follow-up. We applied mixed models to assess whether the evolution over time of depressive symptoms, anxiety, sense of coherence and quality of life differed between the intervention and control arm, taking into account the women’s pre-pregnancy BMI. There was no statistical evidence for a difference in evolution in anxiety or quality of life between intervention and control arm. But an improvement in symptoms of depression and sense of coherence was observed in women who received the intervention, depending on the mother’s pre-pregnancy BMI. Women with normal/overweight pre-pregnancy BMI, reported a decrease in EPDS between baseline and end of intervention, and the decrease was larger in the intervention arm (control arm: -0.42 (95% CI, -0.76 to -0.08); intervention arm: -0.71 (95% CI, -1.07 to -0.35)). Women with pre-pregnancy obesity showed an increase in EPDS between baseline and end of intervention, but the increase was less pronounced in the intervention arm (control arm: +0.71 (95% CI, -0.12 to 1.54); intervention arm: +0.42 (95% CI -0.42 to 1.25)). Women with a normal or obese pre-pregnancy BMI in the intervention arm showed a decrease in sense of coherence between baseline and end of intervention (-0.36) (95% CI, -1.60 to 0.88), while women with overweight pre-pregnancy showed an increase in sense of coherence (+1.53) (95% CI, -0.08 to 3.15) between baseline and end of intervention. Receiving the INTER-ACT postpartum lifestyle intervention showed improvement in depressive symptoms, in normal weight or overweight women on the short run, as well as improvement in sense of coherence in women with pre-pregnancy overweight only. Trial registration: ClinicalTrials.gov;NCT02989142.

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Mental health after childbirth and the impact on postpartum weight retention and body composition. Data from the INTER‐ACT randomized controlled trial

Cited by 4 publications

References 42 publications

The impact of self-monitoring physical and mental health via an mHealth application on postpartum weight retention: Data from the INTER-ACT RCT

The impact of self-monitoring physical and mental health via an mHealth application on postpartum weight retention: Data from the INTER-ACT RCT

Mental Health during the Interpregnancy Period and the Association with Pre-Pregnancy Body Mass Index and Body Composition: Data from the INTER-ACT Randomized Controlled Trial

Effect of the INTER-ACT lifestyle intervention on maternal mental health during the first year after childbirth: A randomized controlled trial

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