Abstract
BackgroundDepression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression.MethodsIn this cross-sectional observational study, baseline data from early pregnancy (< 20 weeks) of the DALI (Vitamin D and Lifestyle Intervention for gestational diabetes mellitus prevention) study were analyzed. Maternal mental health was assessed with the World Health Organization Well-Being Index (WHO–5). Women were classified as having a low (WHO–5 ≤ 50) or high wellbeing.Results.A total of 735 pregnant women were included. The prevalence of having a low wellbeing was 27.2%, 95% CI [24.0, 30.4]. Multivariate analysis showed independent associations between low wellbeing and European ethnicity, OR = .44, 95% CI [.25, .77], shift work, OR = 1.81, 95% CI [1.11, 2.93], insufficient sleep, OR = 3.30, 95% CI [1.96, 5.55], self-efficacy, OR = .95, 95% CI [.92, .98], social support, OR = .94, 95% CI [.90, .99], and pregnancy-related worries (socioeconomic: OR = 1.08, 95% CI [1.02, 1.15]; health: OR = 1.06, 95% CI [1.01, 1.11]; relationship: OR = 1.17, 95% CI [1.05, 1.31]).ConclusionsMental health problems are common in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes.Trial registrationISRCTN70595832, 02.12.2011.
Highlights
Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child
There is a reciprocal relationship between poor mental health and obesity [11] and both have been linked with numerous adverse pregnancy outcomes such as neonatal intensive care requirement, preterm birth and gestational diabetes [24, 32, 33]
The present study demonstrated an association between maternal mental health and European ethnicity, which is in line with previous studies, showing both independent and mutual influences of ethnicity and variables of socioeconomic status on maternal mental health [16, 44, 45]
Summary
Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. Depression alone has a cross-cultural lifetime prevalence from 1 to 17% [3] and has a substantial influence both on disability and mortality [4]. It is associated with various adverse health conditions such as unexplained somatic symptoms [5], cardiovascular disease [6, 7], type 2 diabetes [8], HIV/AIDS [9] and tuberculosis [10]. Maternal depression appears to be inversely related with physical activity (PA) [18] and there is evidence to suggest that PA can help to reduce antenatal depression [19] as well as improve maternal physical health [20]
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