Abstract
BackgroundAlthough studies have shown an association between anxiety and depression and obesity, psychological health among obese women during and after pregnancy has not been carefully studied. The aim of this study was to investigate psychological well-being using symptoms of depression and/or anxiety among obese pregnant women attending a weight gain restriction program and to then compare this group with a control group receiving traditional antenatal care.Methods151 obese pregnant women in an intervention group and 188 obese pregnant women in a control group answered the Beck Anxiety Inventory (BAI) and the Edinburgh Postnatal Depression Scale (EPDS). Group differences between the two groups were estimated by using the χ2 - test on categorical variables. The Student's t-test on continuous, normally distributed variables measuring changes in mean score on BAI and EPDS over time was used. To make a more comprehensive assessment of group differences, between as well as within the two groups, logistic regressions were performed with the BAI and EPDS as dependent variables, measured at gestational weeks 15 and 35 and 11 weeks postnatal. The grouping variable has been adjusted for socio-demographic variables and complications.ResultsThe prevalence of symptoms of anxiety during pregnancy varied between 24% and 25% in the intervention group and 22% and 23% in the control group. The prevalence of symptoms of anxiety postnatally was 9% in the intervention group and 11% in the control group. Five percent of the women in the intervention group and 4% of the women in the control group showed symptoms of anxiety during the course of pregnancy and at the postpartum assessment. The prevalence of symptoms of depression during pregnancy varied between 19% and 22% in the intervention group but was constant at 18% in the control group. Postnatal prevalence was 11% in both groups. Six percent of the women in the intervention group and 4% in the control group showed symptoms of depression during the course of pregnancy and at the postpartum assessment. We found no differences between the two groups as concerns demographic characteristics, weight gain in kg, or the distribution of scores on anxiety and depressive symptoms nor did we find differences in the fluctuation of anxiety and depressive symptoms over time between the women in the intervention group and in the control group.ConclusionObese pregnant women attending an intervention program seem to have the same risk of experiencing anxiety and/or depressive symptoms as do obese pregnant and postnatal women in general.
Highlights
Studies have shown an association between anxiety and depression and obesity, psychological health among obese women during and after pregnancy has not been carefully studied
Anxiety symptoms In analyses of the anxiety symptoms using the Beck Anxiety Inventory (BAI), no significant differences in the prevalence of symptoms were found between the groups (Table 1)
Bivariate analysis showed that there was a difference within the intervention group due to socioeconomic factors at the time of the two measurements during pregnancy (p = .045 and p = .000)
Summary
Studies have shown an association between anxiety and depression and obesity, psychological health among obese women during and after pregnancy has not been carefully studied. The aim of this study was to investigate psychological well-being using symptoms of depression and/or anxiety among obese pregnant women attending a weight gain restriction program and to compare this group with a control group receiving traditional antenatal care. There is an association between depression, anxiety and Rubertsson et al found a prevalence of 14% in early pregnancy and 11-14% during the first year postpartum [12]. In a stratified random sample of approximately 600 obese women, 30.8% reported moderate or greater depressive symptoms compared with 22.8% in a similar sample consisting of about 1800 normal weight women, two to six months postpartum. Krause and coworkers investigated the prevalence of postpartum depression among approximately 500 overweight and obese postpartum women, recruited from a randomized controlled intervention study designed to encourage postnatal weight loss through increased physical activity and decreased caloric intake [16]. In this study the prevalence of depression was 9.2% and there was no relationship between BMI and postpartum depression
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