Psychological Distress and Weight Gain in Pregnancy: a Population-Based Study

Abstract

Background Psychological distress and inappropriate or excessive weight gain are common in pregnancy and are associated with adverse maternal and offspring outcomes. Psychological well-being and weight status of women during pregnancy might be interrelated. We aimed to examine whether psychological distress during pregnancy is associated with gestational weight gain. Method In a population-based cohort of 3393 pregnant women, information about psychological distress, depressive and anxiety symptoms was assessed at 20 weeks of gestation using the Brief Symptom Inventory questionnaire. Weight was repeatedly measured during pregnancy and obtained by questionnaire before and after pregnancy. Linear regression and multinomial logistic regression models were used. Weight gain in the second half of pregnancy, total weight gain, and the risks of inadequate and excessive total weight gain were the main outcome measures. Results In total, 7.0% of all women experienced psychological distress. Overall psychological distress and anxiety were associated with lower weight gain in the second half of pregnancy (differences − 1.00 kg (95% confidence interval (CI) − 1.62, − 0.37) and − 0.68 kg (95% CI-1.24,-0.11), respectively). These associations fully attenuated into non-significance after taking account for socio-demographic variables. Similar results were observed for total weight gain. Only women with anxiety symptoms had, independently of potential confounders, a lower risk of excessive weight gain (odds ratio (OR) 0.61 (95% CI 0.48, 0.91)). Conclusions In this large prospective cohort study, the observed associations of psychological distress with weight gain during pregnancy seem to be largely explained by common socio-demographic factors.

Maternal mental health and gestational weight gain in a Brazilian Cohort

“…However, anxiety symptoms were not associated with GWG below IOM guidelines. Vehmeijer, et al 4 used data from a population-based cohort of 3,393 pregnant women and found that those with anxiety symptoms had a 40% lower risk of excessive weight gain, but the symptoms were not associated with increased risk of insufficient GWG, a result in line with the current study. On the other hand, Braig, et al 45 , did not find significant associations between anxiety symptoms and GWG trajectories during pregnancy in a sample of German women.…”

“…The distinction between the results of Braig, et al 45 and ours may be attributed to differences in the scale used to assess anxiety symptoms and the fact that in their study, anxiety was retrospectively reported after delivery. Although Vehmeijer et al 4 used a different scale to estimate anxiety symptoms, they also evaluated it at the second trimester of pregnancy.…”

Gestational weight gain outside the 2009 Institute of Medicine recommendations: novel psychological and behavioural factors associated with inadequate or excess weight gain in a prospective cohort study

“…Although anxiety was strongly associated with inadequate GWG in the current study, this relationship has been inconsistently demonstrated in the previous literature [ 28 – 30 ] and may involve complex interactions with physiological, psychological, and environmental factors such as chronic stress and anxiety, coping mechanisms, and hormonal pathways. Stress can manifest in overeating or undereating behaviours in different women [ 31 ].…”

Determinants of excessive gestational weight gain: a systematic review and meta-analysis

“…Two studies reported that psychological distress during pregnancy, such as depression [ 23 ] and anxiety [ 42 ], reduced the risk of EGWG. However, other studies reported that psychological distress was not associated with EGWG [ 24 , 36 , 43 – 46 ].…”