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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study

Authors: Ing-Marie Claesson, Ann Josefsson, Gunilla Sydsjö

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Although 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.

Methods

151 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.

Results

The 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.

Conclusion

Obese 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.
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Literature
1.
go back to reference Lawrence VJ, Kopelman PG: Medical consequences of obesity. Clin Dermatol. 2004, 22 (4): 296-302. 10.1016/j.clindermatol.2004.01.012.CrossRefPubMed Lawrence VJ, Kopelman PG: Medical consequences of obesity. Clin Dermatol. 2004, 22 (4): 296-302. 10.1016/j.clindermatol.2004.01.012.CrossRefPubMed
2.
go back to reference Pickering RP, Grant BF, Chou SP, Compton WM: Are overweight, obesity, and extreme obesity associated with psychopathology? Results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2007, 68 (7): 998-1009. 10.4088/JCP.v68n0704.CrossRefPubMed Pickering RP, Grant BF, Chou SP, Compton WM: Are overweight, obesity, and extreme obesity associated with psychopathology? Results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2007, 68 (7): 998-1009. 10.4088/JCP.v68n0704.CrossRefPubMed
3.
go back to reference Heo M, Pietrobelli A, Fontaine KR, Sirey JA, Faith MS: Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race. Int J Obes (Lond). 2006, 30 (3): 513-519. 10.1038/sj.ijo.0803122.CrossRef Heo M, Pietrobelli A, Fontaine KR, Sirey JA, Faith MS: Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race. Int J Obes (Lond). 2006, 30 (3): 513-519. 10.1038/sj.ijo.0803122.CrossRef
4.
go back to reference Simon GE, Von Korff M, Saunders K, Miglioretti DL, Crane PK, van Belle G, Kessler RC: Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry. 2006, 63 (7): 824-830. 10.1001/archpsyc.63.7.824.CrossRefPubMedPubMedCentral Simon GE, Von Korff M, Saunders K, Miglioretti DL, Crane PK, van Belle G, Kessler RC: Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry. 2006, 63 (7): 824-830. 10.1001/archpsyc.63.7.824.CrossRefPubMedPubMedCentral
5.
go back to reference van der Merwe MT: Psychological correlates of obesity in women. Int J Obes (Lond). 2007, 31 (Suppl 2): S14-18. 10.1038/sj.ijo.0803731. discussion S31-12CrossRef van der Merwe MT: Psychological correlates of obesity in women. Int J Obes (Lond). 2007, 31 (Suppl 2): S14-18. 10.1038/sj.ijo.0803731. discussion S31-12CrossRef
6.
go back to reference Atlantis E, Baker M: Obesity effects on depression: systematic review of epidemiological studies. Int J Obes (Lond). 2008, 32 (6): 881-891. 10.1038/ijo.2008.54.CrossRef Atlantis E, Baker M: Obesity effects on depression: systematic review of epidemiological studies. Int J Obes (Lond). 2008, 32 (6): 881-891. 10.1038/ijo.2008.54.CrossRef
7.
go back to reference Barry D, Pietrzak RH, Petry NM: Gender differences in associations between body mass index and DSM-IV mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Ann Epidemiol. 2008, 18 (6): 458-466. 10.1016/j.annepidem.2007.12.009.CrossRefPubMedPubMedCentral Barry D, Pietrzak RH, Petry NM: Gender differences in associations between body mass index and DSM-IV mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Ann Epidemiol. 2008, 18 (6): 458-466. 10.1016/j.annepidem.2007.12.009.CrossRefPubMedPubMedCentral
8.
go back to reference Strine TW, Mokdad AH, Dube SR, Balluz LS, Gonzalez O, Berry JT, Manderscheid R, Kroenke K: The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults. Gen Hosp Psychiatry. 2008, 30 (2): 127-137. 10.1016/j.genhosppsych.2007.12.008.CrossRefPubMed Strine TW, Mokdad AH, Dube SR, Balluz LS, Gonzalez O, Berry JT, Manderscheid R, Kroenke K: The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults. Gen Hosp Psychiatry. 2008, 30 (2): 127-137. 10.1016/j.genhosppsych.2007.12.008.CrossRefPubMed
9.
go back to reference Ma J, Xiao L: Obesity and Depression in US Women: Results From the 2005-2006 National Health and Nutritional Examination Survey. Obesity (Silver Spring). 2009 Ma J, Xiao L: Obesity and Depression in US Women: Results From the 2005-2006 National Health and Nutritional Examination Survey. Obesity (Silver Spring). 2009
10.
go back to reference Josefsson A, Berg G, Nordin C, Sydsjo G: Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand. 2001, 80 (3): 251-255.CrossRefPubMed Josefsson A, Berg G, Nordin C, Sydsjo G: Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand. 2001, 80 (3): 251-255.CrossRefPubMed
11.
go back to reference Robertson E, Grace S, Wallington T, Stewart DE: Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004, 26 (4): 289-295. 10.1016/j.genhosppsych.2004.02.006.CrossRefPubMed Robertson E, Grace S, Wallington T, Stewart DE: Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004, 26 (4): 289-295. 10.1016/j.genhosppsych.2004.02.006.CrossRefPubMed
12.
go back to reference Rubertsson C, Wickberg B, Gustavsson P, Radestad I: Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Womens Ment Health. 2005, 8 (2): 97-104. 10.1007/s00737-005-0078-8.CrossRefPubMed Rubertsson C, Wickberg B, Gustavsson P, Radestad I: Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Womens Ment Health. 2005, 8 (2): 97-104. 10.1007/s00737-005-0078-8.CrossRefPubMed
13.
go back to reference Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H: Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatry. 2004, 19 (8): 459-463. 10.1016/j.eurpsy.2004.09.025.CrossRefPubMed Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H: Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatry. 2004, 19 (8): 459-463. 10.1016/j.eurpsy.2004.09.025.CrossRefPubMed
14.
go back to reference Yu CK, Teoh TG, Robinson S: Obesity in pregnancy. BJOG. 2006, 113 (10): 1117-1125. 10.1111/j.1471-0528.2006.00991.x.CrossRefPubMed Yu CK, Teoh TG, Robinson S: Obesity in pregnancy. BJOG. 2006, 113 (10): 1117-1125. 10.1111/j.1471-0528.2006.00991.x.CrossRefPubMed
15.
go back to reference Lacoursiere DY, Baksh L, Bloebaum L, Varner MW: Maternal body mass index and self-reported postpartum depressive symptoms. Matern Child Health J. 2006, 10 (4): 385-390. 10.1007/s10995-006-0075-1.CrossRefPubMed Lacoursiere DY, Baksh L, Bloebaum L, Varner MW: Maternal body mass index and self-reported postpartum depressive symptoms. Matern Child Health J. 2006, 10 (4): 385-390. 10.1007/s10995-006-0075-1.CrossRefPubMed
16.
go back to reference Krause KM, Ostbye T, Swamy GK: Occurrence and Correlates of Postpartum Depression in Overweight and Obese Women: Results from the Active Mothers Postpartum (AMP) Study. Matern Child Health J. 2008 Krause KM, Ostbye T, Swamy GK: Occurrence and Correlates of Postpartum Depression in Overweight and Obese Women: Results from the Active Mothers Postpartum (AMP) Study. Matern Child Health J. 2008
17.
go back to reference Claesson IM, Sydsjo G, Brynhildsen J, Cedergren M, Jeppsson A, Nystrom F, Sydsjo A, Josefsson A: Weight gain restriction for obese pregnant women: a case-control intervention study. BJOG. 2008, 115 (1): 44-50.CrossRefPubMed Claesson IM, Sydsjo G, Brynhildsen J, Cedergren M, Jeppsson A, Nystrom F, Sydsjo A, Josefsson A: Weight gain restriction for obese pregnant women: a case-control intervention study. BJOG. 2008, 115 (1): 44-50.CrossRefPubMed
18.
go back to reference Miller WR, Rollnick S: Motivational interviewing: preparing people for change. 2002, New York: Guilford Press, 2 Miller WR, Rollnick S: Motivational interviewing: preparing people for change. 2002, New York: Guilford Press, 2
19.
go back to reference Beck AT, Epstein N, Brown G, Steer RA: An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988, 56 (6): 893-897. 10.1037/0022-006X.56.6.893.CrossRefPubMed Beck AT, Epstein N, Brown G, Steer RA: An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988, 56 (6): 893-897. 10.1037/0022-006X.56.6.893.CrossRefPubMed
20.
go back to reference Beck AT, Steer RA: BAI Beck Anxiety Inventory Manual Swedish Version. 2005, Stockholm: Psykologiförlaget Beck AT, Steer RA: BAI Beck Anxiety Inventory Manual Swedish Version. 2005, Stockholm: Psykologiförlaget
21.
go back to reference Dent HR, Salkovskis PM: Clinical measures of depression, anxiety and obsessionality in non-clinical populations. Behav Res Ther. 1986, 24 (6): 689-691. 10.1016/0005-7967(86)90066-5.CrossRefPubMed Dent HR, Salkovskis PM: Clinical measures of depression, anxiety and obsessionality in non-clinical populations. Behav Res Ther. 1986, 24 (6): 689-691. 10.1016/0005-7967(86)90066-5.CrossRefPubMed
22.
go back to reference Creamer M, Foran J, Bell R: The Beck Anxiety Inventory in a non-clinical sample. Behav Res Ther. 1995, 33 (4): 477-485. 10.1016/0005-7967(94)00082-U.CrossRefPubMed Creamer M, Foran J, Bell R: The Beck Anxiety Inventory in a non-clinical sample. Behav Res Ther. 1995, 33 (4): 477-485. 10.1016/0005-7967(94)00082-U.CrossRefPubMed
23.
go back to reference Nordhagen T: Beck Anxiety Inventory: Translation and validation of a Norwegian version. 2001 Nordhagen T: Beck Anxiety Inventory: Translation and validation of a Norwegian version. 2001
24.
go back to reference Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987, 150: 782-786. 10.1192/bjp.150.6.782.CrossRefPubMed Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987, 150: 782-786. 10.1192/bjp.150.6.782.CrossRefPubMed
25.
go back to reference Wickberg B, Hwang CP: The Edinburgh Postnatal Depression Scale: validation on a Swedish community sample. Acta Psychiatr Scand. 1996, 94 (3): 181-184. 10.1111/j.1600-0447.1996.tb09845.x.CrossRefPubMed Wickberg B, Hwang CP: The Edinburgh Postnatal Depression Scale: validation on a Swedish community sample. Acta Psychiatr Scand. 1996, 94 (3): 181-184. 10.1111/j.1600-0447.1996.tb09845.x.CrossRefPubMed
26.
go back to reference Murray L, Carothers AD: The validation of the Edinburgh Post-natal Depression Scale on a community sample. Br J Psychiatry. 1990, 157: 288-290. 10.1192/bjp.157.2.288.CrossRefPubMed Murray L, Carothers AD: The validation of the Edinburgh Post-natal Depression Scale on a community sample. Br J Psychiatry. 1990, 157: 288-290. 10.1192/bjp.157.2.288.CrossRefPubMed
27.
go back to reference Harris B, Huckle P, Thomas R, Johns S, Fung H: The use of rating scales to identify post-natal depression. Br J Psychiatry. 1989, 154: 813-817. 10.1192/bjp.154.6.813.CrossRefPubMed Harris B, Huckle P, Thomas R, Johns S, Fung H: The use of rating scales to identify post-natal depression. Br J Psychiatry. 1989, 154: 813-817. 10.1192/bjp.154.6.813.CrossRefPubMed
28.
go back to reference Britton JR: Maternal anxiety: course and antecedents during the early postpartum period. Depress Anxiety. 2007 Britton JR: Maternal anxiety: course and antecedents during the early postpartum period. Depress Anxiety. 2007
29.
go back to reference Breitkopf CR, Primeau LA, Levine RE, Olson GL, Wu ZH, Berenson AB: Anxiety symptoms during pregnancy and postpartum. J Psychosom Obstet Gynaecol. 2006, 27 (3): 157-162. 10.1080/01674820500523521.CrossRefPubMed Breitkopf CR, Primeau LA, Levine RE, Olson GL, Wu ZH, Berenson AB: Anxiety symptoms during pregnancy and postpartum. J Psychosom Obstet Gynaecol. 2006, 27 (3): 157-162. 10.1080/01674820500523521.CrossRefPubMed
30.
go back to reference Leigh B, Milgrom J: Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry. 2008, 8: 24-10.1186/1471-244X-8-24.CrossRefPubMedPubMedCentral Leigh B, Milgrom J: Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry. 2008, 8: 24-10.1186/1471-244X-8-24.CrossRefPubMedPubMedCentral
31.
go back to reference Evans J, Heron J, Francomb H, Oke S, Golding J: Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001, 323 (7307): 257-260. 10.1136/bmj.323.7307.257.CrossRefPubMedPubMedCentral Evans J, Heron J, Francomb H, Oke S, Golding J: Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001, 323 (7307): 257-260. 10.1136/bmj.323.7307.257.CrossRefPubMedPubMedCentral
32.
go back to reference Marcus SM, Flynn HA, Blow FC, Barry KL: Depressive symptoms among pregnant women screened in obstetrics settings. J Womens Health (Larchmt). 2003, 12 (4): 373-380. 10.1089/154099903765448880.CrossRef Marcus SM, Flynn HA, Blow FC, Barry KL: Depressive symptoms among pregnant women screened in obstetrics settings. J Womens Health (Larchmt). 2003, 12 (4): 373-380. 10.1089/154099903765448880.CrossRef
33.
go back to reference Pajulo M, Savonlahti E, Sourander A, Helenius H, Piha J: Antenatal depression, substance dependency and social support. J Affect Disord. 2001, 65 (1): 9-17. 10.1016/S0165-0327(00)00265-2.CrossRefPubMed Pajulo M, Savonlahti E, Sourander A, Helenius H, Piha J: Antenatal depression, substance dependency and social support. J Affect Disord. 2001, 65 (1): 9-17. 10.1016/S0165-0327(00)00265-2.CrossRefPubMed
34.
go back to reference Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, Ericksen J, Ellwood D, Buist A: Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008, 108 (1-2): 147-157. 10.1016/j.jad.2007.10.014.CrossRefPubMed Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, Ericksen J, Ellwood D, Buist A: Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008, 108 (1-2): 147-157. 10.1016/j.jad.2007.10.014.CrossRefPubMed
35.
go back to reference Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C, Sydsjo G: Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol. 2002, 99 (2): 223-228. 10.1016/S0029-7844(01)01722-7.PubMed Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C, Sydsjo G: Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol. 2002, 99 (2): 223-228. 10.1016/S0029-7844(01)01722-7.PubMed
36.
go back to reference Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W: Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med. 2007, 20 (3): 189-209. 10.1080/14767050701209560.CrossRefPubMed Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W: Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med. 2007, 20 (3): 189-209. 10.1080/14767050701209560.CrossRefPubMed
37.
go back to reference Berle JO, Mykletun A, Daltveit AK, Rasmussen S, Holsten F, Dahl AA: Neonatal outcomes in offspring of women with anxiety and depression during pregnancy. A linkage study from The Nord-Trondelag Health Study (HUNT) and Medical Birth Registry of Norway. Arch Womens Ment Health. 2005, 8 (3): 181-189. 10.1007/s00737-005-0090-z.CrossRefPubMed Berle JO, Mykletun A, Daltveit AK, Rasmussen S, Holsten F, Dahl AA: Neonatal outcomes in offspring of women with anxiety and depression during pregnancy. A linkage study from The Nord-Trondelag Health Study (HUNT) and Medical Birth Registry of Norway. Arch Womens Ment Health. 2005, 8 (3): 181-189. 10.1007/s00737-005-0090-z.CrossRefPubMed
38.
go back to reference Vollebregt KC, van der Wal MF, Wolf H, Vrijkotte TG, Boer K, Bonsel GJ: Is psychosocial stress in first ongoing pregnancies associated with pre-eclampsia and gestational hypertension?. BJOG. 2008, 115 (5): 607-615. 10.1111/j.1471-0528.2008.01665.x.CrossRefPubMed Vollebregt KC, van der Wal MF, Wolf H, Vrijkotte TG, Boer K, Bonsel GJ: Is psychosocial stress in first ongoing pregnancies associated with pre-eclampsia and gestational hypertension?. BJOG. 2008, 115 (5): 607-615. 10.1111/j.1471-0528.2008.01665.x.CrossRefPubMed
39.
go back to reference Polit DF, Hungler BP: Nursing research: principles and methods. 1991, Philadelphia: Lippincott Polit DF, Hungler BP: Nursing research: principles and methods. 1991, Philadelphia: Lippincott
Metadata
Title
Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study
Authors
Ing-Marie Claesson
Ann Josefsson
Gunilla Sydsjö
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-766

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