Mental Health during the Interpregnancy Period and the Association with Pre-Pregnancy Body Mass Index and Body Composition: Data from the INTER-ACT Randomized Controlled Trial

Hanne Van Uytsel; Lieveke Ameye; Roland Devlieger; Yves Jacquemyn; Caroline Van Holsbeke; Annick Schreurs; Annick Bogaerts

doi:10.3390/nu15143152

Mental Health during the Interpregnancy Period and the Association with Pre-Pregnancy Body Mass Index and Body Composition: Data from the INTER-ACT Randomized Controlled Trial

Nutrients. 2023 Jul 14;15(14):3152. doi: 10.3390/nu15143152.

Authors

Hanne Van Uytsel¹, Lieveke Ameye¹, Roland Devlieger^{1

2

3}, Yves Jacquemyn^{4

5}, Caroline Van Holsbeke⁶, Annick Schreurs⁷, Annick Bogaerts^{1

8

9}

Affiliations

¹ REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
² Department of Obstetrics and Gynecology, University Hospital Leuven, 3000 Leuven, Belgium.
³ Department of Obstetrics and Gynecology, GZA Hospitals Sint-Augustinus, 2610 Antwerp, Belgium.
⁴ Global Health Institute (GHI), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium.
⁵ Department of Obstetrics and Gynecology, University Hospital Antwerp, 2650 Antwerp, Belgium.
⁶ Department of Obstetrics and Gynecology, Hospital Oost-Limburg, 3600 Genk, Belgium.
⁷ Department of Obstetrics and Gynecology, Jessa Hospital, 3500 Hasselt, Belgium.
⁸ Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium.
⁹ Faculty of Health, University of Plymouth, Devon PL4 8AA, UK.

Abstract

Mental health problems and obesity are two common complications during pregnancy and postpartum. The preconception period is considered an appropriate period for prevention. Therefore, insights into interpregnancy mental health and the impact on weight and body composition are of interest to developing effective weight management strategies. The primary aim of this study is to assess the difference in women's mental health during the interpregnancy period and the association with pre-pregnancy body mass index (BMI) and body composition. The secondary aim is to study whether this association is affected by socio-demographic factors, interpregnancy interval and sleep. The study is a secondary analysis of the INTER-ACT e-health-supported lifestyle trial. Women were eligible if they had a subsequent pregnancy and mental health measurements at 6 weeks after childbirth and at the start of the next pregnancy (n = 276). We used univariate analyses to assess differences in mental health and performed regression analysis to assess their association with pre-pregnancy BMI and body composition at the start of the next pregnancy. Our results show a statistically significant increase in anxiety and depressive symptoms between 6 weeks after childbirth and the start of the next pregnancy (sSTAI-6 ≥ 40: +13%, p =≤ 0.001; GMDS ≥ 13: +9%, p = 0.01). Of the women who were not anxious at 6 weeks after childbirth (sSTAI < 40), more than one-third (39%) developed anxiety at the start of the next pregnancy (p =≤ 0.001). Regression analysis showed that sense of coherence (SOC-13) at the start of the next pregnancy was independently associated with women's pre-pregnancy BMI and fat percentage. We believe that the development of preconception lifestyle interventions that focus on both weight reduction and support in understanding, managing and giving meaning to stressful events (sense of coherence) may be of added value in optimizing women's preconception health.

Keywords: anxiety; depressive symptoms; interpregnancy; preconception; quality of life; sense of coherence; sleep.

Publication types

Randomized Controlled Trial

MeSH terms

Body Composition
Body Mass Index
Female
Humans
Mental Health*
Obesity* / epidemiology
Postpartum Period
Pregnancy

Grants and funding

This research was funded by the Flemish fund for Scientific research (FWO), grant numbers 1803311N and TN005116N, and the Rotary Foundation, Limburg (Houthalen), Belgium.