Zhou Xuan, Rao Lin, Yang Dongjian, Wang Tong, Li Hong, Liu Zhiwei
School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Road, Xuhui District, 200030, Shanghai, China.
Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China.
BMC Pregnancy Childbirth. 2023 Mar 18;23(1):188. doi: 10.1186/s12884-023-05502-y.
Maternal obesity is the most common medical condition among women of reproductive age worldwide. The pre-pregnancy body mass index and gestational weight gain have been suggested to be associated with maternal mental disorders. This study aimed to investigate the effects of the pre-pregnancy body mass index and gestational weight gain on antenatal depression, stress, and anxiety.
In total, 4,890 pregnant women were enrolled in the present study, which is based on an ongoing prospective cohort study. We used self-reported pre-pregnancy weights and the last weights measured prior to delivery (using professional instruments) to calculate the pre-pregnancy body mass index and gestational weight gain. The questionnaires used included the Center for Epidemiologic Studies Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and 10-item version of the Perceived Stress Scale (PSS-10). We used Pearson product-moment correlation and multivariable logistic regression models to examine the impact of the pre-pregnancy body mass index and gestational weight gain on different maternal mental disorders.
After adjusting for conception, annual household income, occupation, education, smoking status, and drinking status, excessive gestational weight gain during pregnancy was associated with a greater chance of anxiety symptoms in the entire sample (adjusted model: odds ratio = 1.479, 95% confidence interval = 1.128, 1.938) and especially in women with a normal body mass index (adjusted model: odds ratio = 1.668, 95% confidence interval = 1.209, 2.302). However, the relationship between the maternal pre-pregnancy body mass index and mental health was not significant.
Pregnant women with a normal pre-pregnancy body mass index had a greater chance of experiencing anxiety symptoms before delivery if gestational weight gain was excessive; however, its effects on depression or stress symptoms were not observed. The maternal pre-pregnancy body mass index may not be independently associated with maternal mental disorders.
孕产妇肥胖是全球育龄妇女中最常见的医学状况。孕前体重指数和孕期体重增加被认为与孕产妇精神障碍有关。本研究旨在调查孕前体重指数和孕期体重增加对产前抑郁、压力和焦虑的影响。
本研究共纳入4890名孕妇，该研究基于一项正在进行的前瞻性队列研究。我们使用自我报告的孕前体重和分娩前最后测量的体重（使用专业仪器）来计算孕前体重指数和孕期体重增加。使用的问卷包括流行病学研究中心抑郁量表（CES-D）、自评焦虑量表（SAS）和感知压力量表10项版（PSS-10）。我们使用Pearson积矩相关和多变量逻辑回归模型来检验孕前体重指数和孕期体重增加对不同孕产妇精神障碍的影响。
在调整受孕、家庭年收入、职业、教育、吸烟状况和饮酒状况后，孕期体重过度增加与整个样本中出现焦虑症状的可能性更大相关（调整模型：优势比=1.479，95%置信区间=1.128，1.938），尤其是在体重指数正常的女性中（调整模型：优势比=1.668，95%置信区间=1.209，2.302）。然而，孕产妇孕前体重指数与心理健康之间的关系并不显著。
孕前体重指数正常的孕妇，如果孕期体重增加过多，在分娩前出现焦虑症状的可能性更大；然而，未观察到其对抑郁或压力症状的影响。孕产妇孕前体重指数可能与孕产妇精神障碍无独立关联。
