Stress and Anxiety are Associated with Lower Gestational Weight Gain in Hispanic Women.

Abstract

Prior studies indicate that inadequate and excessive gestational weight gain (GWG) are associated with poor maternal and infant outcomes, and that stress and anxiety may contribute to GWG. However, these studies often failed to use validated measures of stress and anxiety, measured only total GWG, and were limited to largely non-Hispanic White populations. We explored the association between stress and anxiety and GWG. We used data from 1,308 participants in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women 18-40years of age (2006-2012). We measured stress with the Perceived Stress Scale and anxiety with the State-Trait Anxiety Scale, and abstracted GWG from medical records. The average GWG was 31.0±16.1 pounds. More than one-half of participants (51.8%) exceeded Institute of Medicine guidelines for GWG. After adjusting for age and pre-pregnancy body mass index, women in the highest quartiles of stress and anxiety in early pregnancy had approximately 4 lbs lower GWG (β=-3.89; SE=1.54; p=.012 and β=-4.37; SE=1.54; p=.005, respectively) as compared with those in the lowest quartiles. Similarly, women in the highest quartiles of mid/late pregnancy stress and anxiety had lower GWG (β=-3.84 lbs; SE=1.39; p=.006, and β=-3.51 lbs; SE=1.38; p=.011, respectively) and a lower rate of GWG in the second and third trimesters (β=-0.117 lbs/week; SE=0.044; p=.008 and β=-0.116 lbs/week; SE=0.043; p=.007, respectively), compared with those in the lowest quartiles. High stress and anxiety were associated with lower GWG. Interventions to decrease stress and anxiety during pregnancy should include counseling on maintaining healthy GWG.