Obesity and anxiety during pregnancy and postpartum: A systematic review.
BACKGROUND
Obesity and anxiety during the perinatal period are common and associated with poor health outcomes for the mother and the child. Despite the well-documented health risks of both pregnancy obesity and anxiety, associations between the two have rarely been explored. With this review we aim to provide a systematic overview of the current state of evidence concerning associations between ante- and postnatal anxiety and pregnancy obesity, excessive gestational weight gain, and postpartum weight retention.


METHODS
We conducted a systematic literature search in PubMed, Web of Science, and PsychINFO.


RESULTS
13 Records matched our inclusion criteria. Five out of seven studies focusing on pregnancy obesity and anxiety suggest a positive association with ante- or postnatal anxiety. Surprisingly, no study examined anxiety disorders according to DSM and it remains unknown whether anxiety symptomatology reaches clinical relevance. Results from a small number of life-style intervention studies (n=3) suggest that interventions could benefit from a stronger focus on mental health. There were not enough studies on associations between excessive gestational weight gain (n=2) or postpartum weight retention (n=3) and anxiety making it difficult to draw conclusions about possible associations.


CONCLUSIONS
The number of included studies is rather small and studies were included irrespective of the study quality which might limit the generalizability of the results.


CONCLUSIONS
The majority of the included studies suggest that obese pregnant women might constitute a subgroup that is especially vulnerable for comorbid anxiety and in need of targeted psychological support. However, further high-quality studies, particularly including anxiety disorders, are needed.
Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany. Electronic address: michaela.nagl@medizin.uni-leipzig.de.
Michaela
M
Nagl
Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.
Katja
K
Linde
Department of Obstetrics, University of Leipzig, Leipzig, Germany.
Holger
H
Stepan
Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.
Anette
A
Kersting
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology*; D001835:Body Weight; D005260:Female; D006801:Humans; D009765:Obesity / Q000523:psychology*; D036801:Parturition / Q000523:psychology; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000523:psychology*; D015430:Weight Gain; D055815:Young Adult
Anxiety; Excessive gestational weight gain; Obesity; Postpartum weight retention; Pregnancy; Review