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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.

SUBMITTER: Vehmeijer FOL

PROVIDER: S-EPMC7058670 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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

Vehmeijer Florianne O L FOL Balkaran Sangeeta R SR Santos Susana S Gaillard Romy R Felix Janine F JF Hillegers Manon H J MHJ El Marroun Hanan H Jaddoe Vincent W V VWV

International journal of behavioral medicine 20200201 1

<h4>Background</h4>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.<h4>Method</h4>In a population-based cohort of 3393 pregnant women, information about psychological distress, depressive an ...[more]

PMID: 31853868

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Project description:BackgroundStudies suggest maternal weight and weight gain during pregnancy may influence foetal immunological development. However, their role in the aetiology of allergic disease is unclear.ObjectivesWe sought to examine the impact of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on the incidence of four common paediatric allergic diseases.MethodsWe conducted a retrospective, population-based cohort study of all singleton live births in Ontario, Canada between 2012 and 2014, using maternal-newborn records from the provincial birth registry linked with health administrative databases. Neonates were followed up to 7 years for anaphylaxis, asthma, dermatitis and rhinitis, identified through validated algorithms based on healthcare encounters. We multiply imputed missing data and employed Cox proportional-hazards models to calculate adjusted hazard ratios (aHR) with 95% confidence intervals (CI). To test the robustness of our findings, we also conducted several sensitivity analyses, including probabilistic bias analyses for exposure and outcome misclassification. All methods were prespecified in a published protocol.ResultsOf the 248,017 infants followed, 52% were born to mothers with a pre-pregnancy BMI in the normal range and only 19% were born to mothers with adequate weight gain during pregnancy. Incidence rates (per 100,000 person-days) for anaphylaxis, asthma, dermatitis and rhinitis were 0.22, 6.80, 12.41 and 1.54, respectively. Compared with normal BMI, maternal obesity was associated with increased hazards of asthma in offspring (aHR 1.08, 95% CI 1.05, 1.11), but decreased hazards of anaphylaxis (aHR 0.83, 95% CI 0.69, 0.99) and dermatitis (aHR 0.97, 95% CI 0.94, 0.99). In contrast, maternal underweight was associated with increased hazards of dermatitis (aHR 1.06, 95% CI 1.02, 1.10). We found no associations between pre-pregnancy BMI and rhinitis or GWG and any allergic outcome, and no evidence of effect measures modification by infant sex.ConclusionsThese findings provide support for the involvement of maternal pre-pregnancy BMI in paediatric allergic disease development.

Project description:Clinically significant psychological distress in pregnancy is common, with epidemiological research suggesting that between 15 and 25 % of pregnant women experience elevated symptoms of stress, anxiety, and depression. Untreated psychological distress in pregnancy is associated with poor obstetrical outcomes, changes in maternal physiology, elevated incidence of child physical and psychological disorders, and is predictive of maternal postpartum mood disorders. Despite the wide-ranging impact of antenatal psychological distress on mothers and their children, there is a gap in our knowledge about the most effective treatments that are available for psychological distress experienced in pregnancy. Additionally, no trials have focused on potential physiological changes that may occur as a result of receiving mindfulness training in pregnancy. The proposed trial will determine the effectiveness of an 8-week modified Mindfulness-based Cognitive Therapy (MBCT) intervention delivered during pregnancy.A randomized controlled trial (RCT) design with repeated measures will be used to evaluate the effectiveness of MBCT to treat psychological distress in pregnancy. A sample of 60 consenting pregnant women aged 18 years and above will be enrolled and randomized to the experimental (MBCT) or control (treatment as usual) condition. Primary (e.g., symptoms of stress, depression, and anxiety), secondary (cortisol, blood pressure (BP), heart rate variability (HRV), and sleep) and other outcome data (e.g., psychological diagnoses) will be collected via a combination of laboratory visits and at-home assessments from both groups at baseline (T1), immediately following the intervention (T2), and at 3 months postpartum (T3). Descriptive statistics will be used to describe sample characteristics. Data will be analyzed using an intention-to-treat approach. Hierarchical linear models will be used to test intervention effects on primary and secondary outcomes.The trial is expected to improve knowledge about evidence-based treatments for psychological distress experienced in pregnancy and to evaluate the potential impact of mindfulness-based interventions on maternal physiology.ClinicalTrials.gov: NCT02214732 , registered on 7 August 2014. Protocol Version 2.0., 5 September 2016.

Project description:BackgroundExperimental evidence suggests that exposures to phthalates and bisphenols may interfere with processes related to glucose and lipid metabolism, insulin sensitivity, and body weight. Few studies have considered the possible influence of chemical exposures during pregnancy on maternal weight gain or metabolic health outcomes postpartum.ObjectiveTo examine the associations of early and mid-pregnancy bisphenol and phthalate urine concentrations with maternal weight gain 6 years postpartum.MethodsWe analyzed urine samples for bisphenol, phthalate and creatinine concentrations from early and mid-pregnancy in 1192 women in a large, population-based birth cohort in Rotterdam, the Netherlands, and examined postpartum weight gain using maternal anthropometrics before pregnancy and 6 years postpartum. We have used covariate-adjusted linear regressions to evaluate associations of early and mid-pregnancy bisphenols and phthalate metabolites with weight change. Mediator and interaction models have been used to assess the role of gestational weight gain and breastfeeding, respectively. Sensitivity analysis is performed among women without subsequent pregnancies.ResultsAmong all 1192 mothers included in the analysis, each log unit increase in the average bisphenol A and all assessed phthalate groupings were associated with increased maternal weight gain. As a proxy for phthalate exposure, each log unit increase in averaged phthalic acid was associated with 734 g weight gain (95% CI 273-1196 g) between pre-pregnancy and 6 years postpartum. Mediation by gestational weight gain was not present. Breastfeeding and ethnicity did not modify the effects. Stratification revealed these associations to be strongest among overweight and obese women. Among women without subsequent pregnancies (n = 373) associations of bisphenols, HMW phthalate metabolites and di-2-ethylhexylphthalate metabolites attenuated. For phthalic acid, LMW phthalate metabolites and di-n-octylphthalate metabolites associations increased. Similarly to the whole group, stratification yielded significant results among overweight and obese women.DiscussionIn a large population-based birth cohort, early and mid-pregnancy phthalate exposures are associated with weight gain 6 years postpartum, particularly among overweight and obese women. These data support ongoing action to replace phthalates with safer alternatives.

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

Publications

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

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