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DOI: 10.1055/s-0036-1571352
Psychological Health and Lifestyle Management Preconception and in Pregnancy
Publication History
Publication Date:
09 February 2016 (online)
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Abstract
Healthful lifestyles before and during pregnancy are important to facilitate healthy outcomes for mother and baby. For example, behaviors such as a sedentary lifestyle and consuming an energy-dense/nutrient-poor diet increase the risk of overweight/obesity before pregnancy and excessive weight gain during pregnancy, leading to adverse maternal and child health outcomes. Maternal psychopathology may be implicated in the development of suboptimal maternal lifestyle behaviors before and during pregnancy, perhaps through impacts on motivation. This article explores this notion using maternal obesity and excessive gestational weight gain as examples of the health impacts of psychological states. We suggest that factors such as psychological well-being, individual motivation for behavior change, and broader environmental influences that affect both individual and system-wide determinants all play important roles in promoting healthy lifestyles periconception and are key modifiable aspects for intervention designers to consider when trying to improve dietary behaviors and increase physical activity before and during pregnancy. In addition, implementing system-wide changes that impact positively on individual and environmental barriers to behavior change that are sustainable, measureable, and effective is required.
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References
- 1 Patra J, Bakker R, Irving H, Jaddoe VWV, Malini S, Rehm J. Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses. BJOG 2011; 118 (12) 1411-1421
- 2 Pineles BL, Park E, Samet JM. Systematic review and meta-analysis of miscarriage and maternal exposure to tobacco smoke during pregnancy. Am J Epidemiol 2014; 179 (7) 807-823
- 3 Hackshaw A, Rodeck C, Boniface S. Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update 2011; 17 (5) 589-604
- 4 Callaway LK, Prins JB, Chang AM, McIntyre HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust 2006; 184 (2) 56-59
- 5 Pantasri T, Norman RJ. The effects of being overweight and obese on female reproduction: a review. Gynecol Endocrinol 2014; 30 (2) 90-94
- 6 Rasmussen KM, Yaktine AL. Weight Gain during Pregnancy: Reexamining the Guidelines. Institute of Medicine, National Research Council; 2013
- 7 Lemas DJ, Brinton JT, Shapiro ALB, Glueck DH, Friedman JE, Dabelea D. Associations of maternal weight status prior and during pregnancy with neonatal cardiometabolic markers at birth: the Healthy Start study. Int J Obes 2015; 39 (10) 1437-1442
- 8 Schack-Nielsen L, Michaelsen KF, Gamborg M, Mortensen EL, Sørensen TIA. Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood. Int J Obes 2010; 34 (1) 67-74
- 9 O'Neil A, Itsiopoulos C, Skouteris H , et al. Preventing mental health problems in offspring by targeting dietary intake of pregnant women. BMC Med 2014; 12: 208
- 10 Chu L, Retnakaran R, Zinman B, Hanley AJ, Hamilton JK. Impact of maternal physical activity and infant feeding practices on infant weight gain and adiposity. Int J Endocrinol 2012; ;2012:293821. Available at: http://www.hindawi.com/journals/ije/2012/293821/ . Accessed November 6, 2015
- 11 Mourtakos SP, Tambalis KD, Panagiotakos DB , et al. Maternal lifestyle characteristics during pregnancy, and the risk of obesity in the offspring: a study of 5,125 children. BMC Pregnancy Childbirth 2015; 15 (1) 66
- 12 Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry 2012; 25 (2) 141-148
- 13 Clark A, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. The relationship between depression and body dissatisfaction across pregnancy and the postpartum: a prospective study. J Health Psychol 2009; 14 (1) 27-35
- 14 Dunkel Schetter C. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol 2011; 62 (1) 531-558
- 15 Fuller-Tyszkiewicz M, Skouteris H, Watson BE, Hill B. Body dissatisfaction during pregnancy: a systematic review of cross-sectional and prospective correlates. J Health Psychol 2013; 18 (11) 1411-1421
- 16 Rallis S, Skouteris H, McCabe M, Milgrom J. A prospective examination of depression, anxiety and stress throughout pregnancy. Women Birth 2014; 27 (4) e36-e42
- 17 Frieder A, Dunlop AL, Culpepper L, Bernstein PS. The clinical content of preconception care: women with psychiatric conditions. Am J Obstet Gynecol 2008; 199 (6) (Suppl. 02) S328-S332
- 18 Skouteris H, Wertheim EH, Rallis S, Milgrom J, Paxton SJ. Depression and anxiety through pregnancy and the early postpartum: an examination of prospective relationships. J Affect Disord 2009; 113 (3) 303-308
- 19 Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 2010; 67 (10) 1012-1024
- 20 Faisal-Cury A, Rossi Menezes P. Prevalence of anxiety and depression during pregnancy in a private setting sample. Arch Women Ment Health 2007; 10 (1) 25-32
- 21 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
- 22 Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results, 2007. Canberra: Commonwealth of Australia; 2008
- 23 Rallis S, Skouteris H, McCabe M, Milgrom J. The transition to motherhood: towards a broader understanding of perinatal distress. Women Birth 2014; 27 (1) 68-71
- 24 Divney AA, Sipsma H, Gordon D, Niccolai L, Magriples U, Kershaw T. Depression during pregnancy among young couples: the effect of personal and partner experiences of stressors and the buffering effects of social relationships. J Pediatr Adolesc Gynecol 2012; 25 (3) 201-207
- 25 Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010; 202 (1) 5-14
- 26 Razurel C, Kaiser B, Sellenet C, Epiney M. Relation between perceived stress, social support, and coping strategies and maternal well-being: a review of the literature. Women Health 2013; 53 (1) 74-99
- 27 Skouteris H. Body image issues in obstetrics and gynecology. In: Cash TF, Smolak L, , eds. Body Image, A Handbook of Science, Practice and Prevention. 2nd ed. New York: Guilford Press; 2011: 342-349
- 28 Thompson JK, Heinberg LJ, Altabe M, Tantleff-Dunn S. Exacting Beauty: Theory, Assessment, and Treatment of Body Image Disturbance. Washington, DC: American Psychological Association; 1999
- 29 Watson B, Fuller-Tyszkiewicz M, Broadbent J, Skouteris H. The meaning of body image experiences during the perinatal period: A systematic review of the qualitative literature. Body Image 2015; 14: 102-113
- 30 Watson B, Broadbent J, Skouteris H, Fuller-Tyszkiewicz M. A qualitative exploration of body image experiences of women progressing through pregnancy. Women and Birth. 2015. Available at: http://www.womenandbirth.org/article/S1871-5192(15)00271-1/abstract . Accessed October 28, 2015
- 31 Skouteris H, Carr R, Wertheim EH, Paxton SJ, Duncombe D. A prospective study of factors that lead to body dissatisfaction during pregnancy. Body Image 2005; 2 (4) 347-361
- 32 Duncombe D, Wertheim EH, Skouteris H, Paxton SJ, Kelly L. How well do women adapt to changes in their body size and shape across the course of pregnancy?. J Health Psychol 2008; 13 (4) 503-515
- 33 Rauff EL, Symons Downs DS. Mediating effects of body image satisfaction on exercise behavior, depressive symptoms, and gestational weight gain in pregnancy. Ann Behav Med 2011; 42 (3) 381-390
- 34 Downs DS, DiNallo JM, Kirner TL. Determinants of pregnancy and postpartum depression: prospective influences of depressive symptoms, body image satisfaction, and exercise behavior. Ann Behav Med 2008; 36 (1) 54-63
- 35 Kamysheva E, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. Examination of a multi-factorial model of body-related experiences during pregnancy: the relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes. Body Image 2008; 5 (2) 152-163
- 36 Kamysheva E, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. A prospective investigation of the relationships among sleep quality, physical symptoms, and depressive symptoms during pregnancy. J Affect Disord 2010; 123 (1–3) 317-320
- 37 Entringer S, Buss C, Wadhwa PD. Prenatal stress, development, health and disease risk: a psychobiological perspective-2015 Curt Richter Award Paper. Psychoneuroendocrinology 2015; 62: 366-375
- 38 Lopresti AL, Hood SD, Drummond PD. A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. J Affect Disord 2013; 148 (1) 12-27
- 39 Skouteris H, Huang T, Millar L , et al. A systems approach to reducing maternal obesity: The Health in Preconception, Pregnancy and Postbirth (HIPPP) Collaborative. Aust N Z J Obstet Gynaecol 2015; 55 (4) 397-400
- 40 van Reedt Dortland AK, Vreeburg SA, Giltay EJ , et al. The impact of stress systems and lifestyle on dyslipidemia and obesity in anxiety and depression. Psychoneuroendocrinology 2013; 38 (2) 209-218
- 41 Jacka FN, Mykletun A, Berk M. Moving towards a population health approach to the primary prevention of common mental disorders. BMC Med 2012; 10 (1) 149
- 42 Mammen G, Faulkner G. Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Prev Med 2013; 45 (5) 649-657
- 43 Maxwell MA, Cole DA. Weight change and appetite disturbance as symptoms of adolescent depression: toward an integrative biopsychosocial model. Clin Psychol Rev 2009; 29 (3) 260-273
- 44 Bernstein EE, Rabideau DJ, Gigler ME, Nierenberg AA, Deckersbach T, Sylvia LG. Patient perceptions of physical health and bipolar symptoms: The intersection of mental and physical health. J Affect Disord 2016; 189: 203-206
- 45 Gaudet C, Wen SW, Walker MC. Chronic perinatal pain as a risk factor for postpartum depression symptoms in Canadian women. Can J Public Health 2013; 104 (5) e375-e387
- 46 Baskin R, Hill B, Jacka FN, O'Neil A, Skouteris H. The association between diet quality and mental health during the perinatal period. A systematic review. Appetite 2015; 91 (0) 41-47
- 47 Baskin R, Hill B, Jacka FN, O'Neil A, Skouteris H. Antenatal dietary patterns and depressive symptoms during pregnancy and early postpartum. Matern Child Nutr Published online 3rd January 2016. doi: 10.1111/mcn.12218
- 48 Boscaglia N, Skouteris H, Wertheim EH. Changes in body image satisfaction during pregnancy: a comparison of high exercising and low exercising women. Aust N Z J Obstet Gynaecol 2003; 43 (1) 41-45
- 49 Robledo-Colonia AF, Sandoval-Restrepo N, Mosquera-Valderrama YF, Escobar-Hurtado C, Ramírez-Vélez R. Aerobic exercise training during pregnancy reduces depressive symptoms in nulliparous women: a randomised trial. J Physiother 2012; 58 (1) 9-15
- 50 Hill B, Skouteris H, McCabe M , et al. A conceptual model of psychosocial risk and protective factors for excessive gestational weight gain. Midwifery 2013; 29 (2) 110-114
- 51 Hill B, Skouteris H, Fuller-Tyszkiewicz M, Kothe E, McPhie S. A path model of psychosocial and health behaviour change predictors of excessive gestational weight gain. J Reprod Infant Psychol Published online 19 January 2016. doi: 10.1080/02646838.2015.1118021
- 52 Fuller-Tyszkiewicz M, Skouteris H, Hill B, Teede H, McPhie S. Classification tree analysis of postal questionnaire data to identify risk of excessive gestational weight gain. Midwifery. 2015. Available at: http://www.sciencedirect.com/science/article/pii/S0266613815002764 . Accessed November 19, 2015
- 53 Marie Stopes International. Real Choices: Women, Contraception, and Unplanned Pregnancy. Melbourne, Vic: 2008
- 54 Roberto CA, Swinburn B, Hawkes C , et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet 2015; 385 (9985) 2400-2409
- 55 Webb TL, Sniehotta FF, Michie S. Using theories of behaviour change to inform interventions for addictive behaviours. Addiction 2010; 105 (11) 1879-1892
- 56 Charach A, Volpe T, Boydell KM, Gearing RE. A theoretical approach to medication adherence for children and youth with psychiatric disorders. Harv Rev Psychiatry 2008; 16 (2) 126-135
- 57 Hardeman W, Griffin S, Johnston M, Kinmonth AL, Wareham NJ. Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. Int J Obes Relat Metab Disord 2000; 24 (2) 131-143
- 58 Dombrowski SU, Sniehotta FF, Avenell A, Johnston M, MacLennan G, Araújo-Soares V. Identifying active ingredients in complex behavioural interventions for obese adults with obesity-related co-morbidities or additional risk factors for co-morbidities: a systematic review. Health Psych Rev 2012; 6 (1) 7-32
- 59 Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health 2011; 26 (11) 1479-1498
- 60 Hill B, Skouteris H, Fuller-Tyszkiewicz M. Interventions designed to limit gestational weight gain: a systematic review of theory and meta-analysis of intervention components. Obes Rev 2013; 14 (6) 435-450
- 61 Gardner B, Wardle J, Poston L, Croker H. Changing diet and physical activity to reduce gestational weight gain: a meta-analysis. Obes Rev 2011; 12 (7) e602-e620
- 62 Huang TT, Drewnosksi A, Kumanyika S, Glass TA. A systems-oriented multilevel framework for addressing obesity in the 21st century. Prev Chronic Dis 2009; 6 (3) A82
- 63 Nader PR, Huang TT-K, Gahagan S, Kumanyika S, Hammond RA, Christoffel KK. Next steps in obesity prevention: altering early life systems to support healthy parents, infants, and toddlers. Child Obes 2012; 8 (3) 195-204
- 64 Phelan S. Pregnancy: a “teachable moment” for weight control and obesity prevention. Am J Obstet Gynecol 2010; 202 (2) 135.e1-135.e8
- 65 Olander EK, Atkinson L, Edmunds JK, French DP. The views of pre- and post-natal women and health professionals regarding gestational weight gain: An exploratory study. Sex Reprod Healthc 2011; 2 (1) 43-48
- 66 Heslehurst N, Newham J, Maniatopoulos G, Fleetwood C, Robalino S, Rankin J. Implementation of pregnancy weight management and obesity guidelines: a meta-synthesis of healthcare professionals' barriers and facilitators using the Theoretical Domains Framework. Obes Rev 2014; 15 (6) 462-486