Abstract
Objective To investigate the association between antenatal depression and anxiety and early pregnancy Body Mass Index (BMI) within and between White British and South Asian women. Design Retrospective analysis Setting The Born in Bradford cohort, UK Population White British and South Asian pregnant women, 2007-2011 Methods Mother’s BMI was stratified into six World Health Organisation BMI categories (underweight, recommended, overweight or obese class 1-3). To determine associations with outcomes, univariate and multivariate logistic regression models (adjusting for maternal age, education, deprivation and smoking) were used. Main outcome measure Depression and anxiety using the General Health Questionnaire (GHQ); a GHQ score of >0 for the depression subscale and >6 for anxiety. Results There were 7824 women included (3514 White British and 4310 South Asian). South Asian women were significantly 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 was no significant association between early pregnancy 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. Conclusion 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.
Highlights
Maternal obesity has severe physical impacts such as increased chances of pre-eclampsia and gestational diabetes
A systematic review and meta-analysis published in 2014 found odds of antenatal depression and anxiety increased by 43 and 30%, respectively, in women with obesity compared to women of recommended Body Mass Index (BMI) [4]
There was an association between ethnicity and antenatal depression and anxiety with a significantly higher proportion of South Asian women with depression compared with White British women, but lower proportion with anxiety, independent of early pregnancy BMI
Summary
Maternal obesity has severe physical impacts such as increased chances of pre-eclampsia and gestational diabetes. Evidence suggests that women with obesity carry increased risk of maternal depression and anxiety, 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. A systematic review and meta-analysis published in 2014 found odds of antenatal depression and anxiety increased by 43 and 30%, respectively, in women with obesity compared to women of recommended BMI [4]. A systematic review [10] investigating the effects of maternal anthropometrics on pregnancy outcomes in South Asian women did not identify any studies on mental health conditions, further highlighting the lack of published data in this field in South Asian women
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