Antenatal depression and anxiety and early pregnancy BMI among White British and South Asian women: retrospective analysis of data from the Born in Bradford cohort

Abstract

Background: Maternal obesity has severe physical impacts such as increased chances of pre-eclampsia and gestational diabetes. However, mental health impacts are given less attention within antenatal care. Evidence suggests that women with obesity carry increased risk of maternal depression and anxiety, however, this association is not well researched amongst South Asian women in the UK who are vulnerable to both. The aim of this study was to investigate the association between antenatal depression and anxiety and early pregnancy BMI, within and between White British and South Asian women, using data from the Born in Bradford cohort. Methods: Depression and anxiety were assessed using the General Health Questionnaire (GHQ); a GHQ score of > 0 for the depression subscale and > 6 for anxiety. Mother's BMI was stratified into six World Health Organisation BMI categories (underweight, recommended, overweight or obese class 1-3). To determine associations, univariate and multivariate logistic regression models (adjusting for maternal age, education, deprivation and smoking) were used. Results: There were 7824 women included (3514 White British and 4310 South Asian). South Asian women were more likely to have depression than White British (43.3% vs 36.1% p < 0.0001) and less likely to have anxiety (45.3% vs 48.4% p < 0.01). There were no significant associations between BMI and depression or anxiety in South Asian women. White British women with an overweight BMI had higher odds of anxiety compared with women with a recommended BMI (Adjusted Odds Ratio 1.25, 95% Confidence Interval 1.05-1.47). No significant associations were observed for other BMI categories. Smoking was a risk factor for antenatal depression (AOR 1.32, 95% CI 1.12-1.56; AOR 2.08, 95% CI 1.49-2.91) and anxiety (AOR 1.34, 95% CI 1.14-1.57; (AOR 2.87, 95% CI 2.02-4.07) in both White British and South Asian women, respectively. Conclusions: Although South Asian women have a higher prevalence of depression than White women in this cohort, the known associations between maternal obesity and anxiety do not appear to be present. More studies are needed using validated depression tools for South Asian pregnant women. Mental health screening during antenatal care is important for South Asian women, with factors such as smoking considered.

Anxiety and depressive symptoms of women in the perinatal period during the COVID-19 pandemic: A systematic review and meta-analysis

“…No statistical difference was found among regions for antenatal depressive symptoms, even though Europe had the highest prevalence (39%), followed by North America (23%) and Asia (22%). These ratings contradicted previous findings which demonstrated that antenatal depression was more common among Asian women than White women [55][56][57]. However, these studies examined the prevalence among different ethnicity groups within a single country and did not compare the prevalence among countries.…”

“…Our review found significant differences in the prevalence of antenatal anxiety between Europe and Asia; Europe had a high prevalence of 56% while Asia had a rate of 16%. There is a lack of regional evidence on antenatal anxiety to support this finding but Insan et al [55] reported a similar lower antenatal anxiety rate among South Asian women compared to White British women living in the United Kingdom. Furthermore, the huge disparity in anxiety prevalence could be due to differences in methodology among the studies such as the psychometric properties of the assessment tools in different languages, or COVID-19 related factors such as differences in mitigation measures implemented in different countries and people's trust in the government to curb the spread of the virus.…”

Gebeliğin Planlı Olma Durumu Ve Gebelik Sayısının Gebelerdeki Sosyal Görünüş Kaygı Düzeyine Etkisi

“…When the literature is examined, it has been determined that there are similar results to our findings and older pregnant women have a better body image (8,18,19). In addition, there are studies in the literature that different results have been obtained, such as that the ages of pregnant women are not related to their external appearance (12,13,16,(20)(21)(22)(23)(24), that is, body image, or that young pregnant women have a better (8,17,25) or worse (26) body image. It can be said that this difference in the literature is due to the individual characteristics of pregnant women.…”

Effect of Excessive Body Weight and Emotional Disorders on the Course of Pregnancy and Well-Being of a Newborn before and during COVID-19 Pandemic

“…The risk of depression is higher in overweight women, and is especially elevated among obese women with BMI ≥30 [5][6][7][8][9][10]. In turn, Insan et al [11], in their study conducted among women of British origin and Asian women, indicated a lack of any relationship between pre-pregnancy BMI and depression, similarly to the study by Molyneux et al [12] on women from Australia, Ireland, New Zealand, and the UK. Despite a large number of available studies, emerging inconsistencies suggest that further research is important, especially with consideration of the same scales for the assessment of depression, and factors strongly mediating the intensity of depressive symptoms.…”