Psychological antecedents of excess gestational weight gain: a systematic review

Abstract

BackgroundExcess gestational weight gain (GWG), which has reached epidemic proportions, is associated with adverse outcomes during pregnancy and postpartum obesity in women and children. Psychological variables represent potentially modifiable factors. Moreover, previous systematic reviews on GWG interventions have called for the need for a clearer understanding of psychological factors affecting GWG. Hence, a systematic review was conducted to summarize the relation between psychological factors and GWG.MethodsEight databases were searched, and the guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Methodological quality of the included studies was assessed using a modified Newcastle-Ottawa scale. Two assessors independently reviewed titles, abstracts and full articles, extracted data and assessed quality.ResultsA total of 6198 titles and abstracts were reviewed of which 90 full text articles were retrieved. Thirty-five studies (25 cohort, eight cross-sectional and two case–control) met the inclusion criteria, assessing 26 different psychological constructs in affect, cognitions and personality. Negative affective states such as depression, anxiety and stress were not related to excess GWG. Among weight-related and dietary-related cognitions, risk factors for excess GWG included concern about weight gain, negative body image and attitude towards weight gain, inaccurate perceptions regarding weight, higher than recommended target weight gain, less knowledge about weight gain, higher levels of cognitive dietary restraint, and perceived barriers to healthy eating. Protective factors included an internal locus of control for weight gain, lower than recommended target weight gain and higher self-efficacy for healthy eating. Only one study examined the relation between personality and excess GWG.ConclusionIn this systematic review, a number of cognitive factors were identified that were associated with excess GWG. To address excess GWG, more high quality, adequately powered studies are required examining cognitions, motivation and personality factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0535-y) contains supplementary material, which is available to authorized users.

Obesity and anxiety during pregnancy and postpartum: A systematic review

“…Although it has been recognized that psychosocial factors play an important role in the epidemiology of GWG and PPWR (Hartley et al, 2015;Hill et al, 2013;Kapadia et al, 2015;Phillips et al, 2012), we identified only two studies with a focus on the association of excessive GWG and anxiety Webb et al, 2009), and only three with a focus on the association between PPWR and anxiety (Bogaerts et al, 2013c;Phillips et al, 2014bPhillips et al, , 2014b. While excessive GWG and PPWR were not related to anxiety in studies from the general pregnant population, one study provides support for an association of anxiety and PPWR among obese pregnant women (Bogaerts et al, 2013c).…”

“…Several underlying and possibly overlapping biological mechanisms may contribute to the comorbidity of obesity and anxiety during pregnancy (Nousen et al, 2013). Neurophysiological dysregulations associated with anxiety might lead to an altered stress response or higher cortisol levels, responses associated with an appetite up-regulation (Kapadia et al, 2015). For example, it has been shown that pregnant women with elevated anxiety during pregnancy consume more food and have a decreased intake of vitamins (Hurley et al, 2005).…”

Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese

“…38 Existing research on the causal relationship between gestational weight gain and prenatal depression likewise presents contradictory findings. 21,22,43,44 The association between postpartum depression and weight loss also is likely to be bidirectional. 45 Future research is needed to replicate and extend these findings, disaggregating potential bidirectional relationships between depression and weight gain and loss trajectories across the perinatal period.…”

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

“…l " Table 2). A much greater importance is attached to modifiable psychosocial and health-related factors [39,40]. For example, studies have shown a correlation between excessive weight gain in pregnancy and dissatisfaction with body image prior to becoming pregnant (e.g.…”