Abstract

Psychosocial stress is thought to influence gestational weight gain (GWG), but results are inconsistent. We investigated the relationship of questionnaire-based maternal stress and related constructs assessed at childbirth with maternal weight measured throughout pregnancy. Data were derived from the Ulm SPATZ Health Study, a birth cohort recruited from the general population (04/2012–05/2013, Ulm, Germany). Adjusted generalized estimating equations were performed. Regression coefficients (b) and 95% confidence intervals, each highest versus lowest tertile of stress or related constructs, are presented. In 748 women, we observed positive associations for maternal chronic stress (b = 4.36 kg (1.77; 6.95)), depressive symptoms (b = 2.50 kg (0.14; 4.86)), anxiety symptoms (b = 3.26 kg (0.62, 5.89)), and hair cortisol (b = 3.35 kg (0.86; 5.83)) with maternal weight at the first gestational month. GWG was considerably lower in mothers with higher chronic stress. Pregnancy-related anxiety was positively related to weight at first month (b = 4.16 kg (1.74; 6.58)) and overall GWG. In contrast, no association was observed between anxiety symptoms and GWG. Odds ratios for association with inadequate weight gain according to Institute of Medicine recommended cutoffs differed from the results presented obove. There is evidence of an association between stress and weight gain lying beyond the recommended cut-offs, which however needs further corroboration.

Highlights

  • Psychosocial stress is thought to influence gestational weight gain (GWG), but results are inconsistent

  • This study aims to investigate the association of stress, anxiety, and depression symptoms with GWG based on paper documentation of routine preventive medical examination including several measurements of body weight

  • Higher pregnancy-related anxiety was associated with higher weight at first pregnancy month and higher GWG

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Summary

Introduction

Psychosocial stress is thought to influence gestational weight gain (GWG), but results are inconsistent. In 748 women, we observed positive associations for maternal chronic stress (b = 4.36 kg (1.77; 6.95)), depressive symptoms (b = 2.50 kg (0.14; 4.86)), anxiety symptoms (b = 3.26 kg (0.62, 5.89)), and hair cortisol (b = 3.35 kg (0.86; 5.83)) with maternal weight at the first gestational month. Evidence for an association between stress and related constructs and weight gain during pregnancy is mixed which may be due to different measurements of stress. One systematic review[10] concluded that maternal depression, but not anxiety or stress during pregnancy appears to have a direct relationship with excessive gestational weight gain (GWG). Another systematic review[11] reported that only one out of the seven included studies observed a negative association between depression and excessive GWG, whereas no link between stress

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