Department of Health Sciences, Springfield College, Springfield, Massachusetts.
Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado.
Womens Health Issues. 2020 Nov-Dec;30(6):409-415. doi: 10.1016/j.whi.2020.08.003. Epub 2020 Sep 28.
Prior studies indicate that inadequate and excessive gestational weight gain (GWG) are associated with poor maternal and infant outcomes, and that stress and anxiety may contribute to GWG. However, these studies often failed to use validated measures of stress and anxiety, measured only total GWG, and were limited to largely non-Hispanic White populations. We explored the association between stress and anxiety and GWG.
We used data from 1,308 participants in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women 18-40 years of age (2006-2012). We measured stress with the Perceived Stress Scale and anxiety with the State-Trait Anxiety Scale, and abstracted GWG from medical records.
The average GWG was 31.0 ± 16.1 pounds. More than one-half of participants (51.8%) exceeded Institute of Medicine guidelines for GWG. After adjusting for age and pre-pregnancy body mass index, women in the highest quartiles of stress and anxiety in early pregnancy had approximately 4 lbs lower GWG (β = -3.89; SE = 1.54; p = .012 and β = -4.37; SE = 1.54; p = .005, respectively) as compared with those in the lowest quartiles. Similarly, women in the highest quartiles of mid/late pregnancy stress and anxiety had lower GWG (β = -3.84 lbs; SE = 1.39; p = .006, and β = -3.51 lbs; SE = 1.38; p = .011, respectively) and a lower rate of GWG in the second and third trimesters (β = -0.117 lbs/week; SE = 0.044; p = .008 and β = -0.116 lbs/week; SE = 0.043; p = .007, respectively), compared with those in the lowest quartiles.
High stress and anxiety were associated with lower GWG. Interventions to decrease stress and anxiety during pregnancy should include counseling on maintaining healthy GWG.
先前的研究表明，妊娠体重增加不足和过多与母婴结局不良有关，而压力和焦虑可能导致妊娠体重增加。然而，这些研究往往没有使用经过验证的压力和焦虑测量工具，仅测量了总妊娠体重增加，并且仅限于非西班牙裔白人为主的人群。我们探讨了压力和焦虑与妊娠体重增加之间的关系。
我们使用了来自 1308 名主要为波多黎各裔妇女（年龄 18-40 岁）的 Proyecto Buena Salud 前瞻性队列研究的数据。我们使用感知压力量表测量压力，使用状态-特质焦虑量表测量焦虑，并从病历中提取妊娠体重增加数据。
平均妊娠体重增加为 31.0±16.1 磅。超过一半的参与者（51.8%）超过了医学研究所的妊娠体重增加指南。在调整年龄和孕前体重指数后，孕早期压力和焦虑最高四分位的女性妊娠体重增加约低 4 磅（β=-3.89；SE=1.54；p=0.012 和β=-4.37；SE=1.54；p=0.005），而最低四分位的女性则较低。同样，孕中期和孕晚期压力和焦虑最高四分位的女性妊娠体重增加也较低（β=-3.84 磅；SE=1.39；p=0.006 和β=-3.51 磅；SE=1.38；p=0.011），且第二和第三孕期的妊娠体重增加率也较低（β=-0.117 磅/周；SE=0.044；p=0.008 和β=-0.116 磅/周；SE=0.043；p=0.007），而最低四分位的女性则较低。
高压力和焦虑与妊娠体重增加较低有关。在怀孕期间减少压力和焦虑的干预措施应包括咨询如何保持健康的妊娠体重增加。
