Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
BMC Pregnancy Childbirth. 2020 Sep 1;20(1):502. doi: 10.1186/s12884-020-03097-2.
Maternal obesity has severe physical impacts such as increased chances of pre-eclampsia and gestational diabetes. However, mental health impacts are given less attention within antenatal care. Evidence suggests that women with obesity carry increased risk of maternal depression and anxiety, however, this association is not well researched amongst South Asian women in the UK who are vulnerable to both. The aim of this study was to investigate the association between antenatal depression and anxiety and early pregnancy BMI, within and between White British and South Asian women, using data from the Born in Bradford cohort.
Depression and anxiety were assessed using the General Health Questionnaire (GHQ); a GHQ score of > 0 for the depression subscale and > 6 for anxiety. Mother's BMI was stratified into six World Health Organisation BMI categories (underweight, recommended, overweight or obese class 1-3). To determine associations, univariate and multivariate logistic regression models (adjusting for maternal age, education, deprivation and smoking) were used.
There were 7824 women included (3514 White British and 4310 South Asian). South Asian women were more likely to have depression than White British (43.3% vs 36.1% p < 0.0001) and less likely to have anxiety (45.3% vs 48.4% p < 0.01). There were no significant associations between BMI and depression or anxiety in South Asian women. White British women with an overweight BMI had higher odds of anxiety compared with women with a recommended BMI (Adjusted Odds Ratio 1.25, 95% Confidence Interval 1.05-1.47). No significant associations were observed for other BMI categories. Smoking was a risk factor for antenatal depression (AOR 1.32, 95% CI 1.12-1.56; AOR 2.08, 95% CI 1.49-2.91) and anxiety (AOR 1.34, 95% CI 1.14-1.57; (AOR 2.87, 95% CI 2.02-4.07) in both White British and South Asian women, respectively.
Although South Asian women have a higher prevalence of depression than White women in this cohort, the known associations between maternal obesity and anxiety do not appear to be present. More studies are needed using validated depression tools for South Asian pregnant women. Mental health screening during antenatal care is important for South Asian women, with factors such as smoking considered.
母体肥胖对身体有严重影响，例如子痫前期和妊娠糖尿病的几率增加。然而，产前护理对心理健康的影响关注较少。有证据表明，肥胖的女性患产妇抑郁和焦虑的风险增加，然而，在英国的南亚妇女中，这种关联并没有得到很好的研究，因为她们同时容易受到这两种情况的影响。本研究的目的是使用布拉德福德出生队列的数据，调查白种英国人和南亚妇女中，产前抑郁和焦虑与早期妊娠 BMI 之间的关系，并在两者之间进行研究。
使用一般健康问卷（GHQ）评估抑郁和焦虑；抑郁分量表得分>0 和焦虑得分>6。母亲的 BMI 分为六个世界卫生组织 BMI 类别（体重不足、推荐、超重或肥胖 1-3 级）。为了确定关联，使用单变量和多变量逻辑回归模型（调整母亲年龄、教育、贫困和吸烟状况）。
共纳入 7824 名女性（白种英国 3514 名，南亚 4310 名）。南亚妇女患抑郁症的比例高于白种英国妇女（43.3%对 36.1%，p<0.0001），患焦虑症的比例低于白种英国妇女（45.3%对 48.4%，p<0.01）。南亚妇女的 BMI 与抑郁或焦虑之间没有显著关联。超重 BMI 的白种英国妇女患焦虑症的几率高于推荐 BMI 的妇女（调整后的优势比 1.25，95%置信区间 1.05-1.47）。其他 BMI 类别未见显著关联。吸烟是产前抑郁的危险因素（优势比 1.32，95%置信区间 1.12-1.56；优势比 2.08，95%置信区间 1.49-2.91）和焦虑症（优势比 1.34，95%置信区间 1.14-1.57；优势比 2.87，95%置信区间 2.02-4.07），分别在白种英国和南亚妇女中。
尽管在本队列中，南亚妇女的抑郁症患病率高于白种妇女，但已知的母体肥胖与焦虑之间的关联似乎并不存在。需要更多使用针对南亚孕妇的经过验证的抑郁工具进行研究。在产前保健期间进行心理健康筛查很重要，应考虑吸烟等因素。
