Maternal and Child Health Journal

, Volume 19, Issue 5, pp 1047–1059 | Cite as

Stress, Sleep, Depression and Dietary Intakes Among Low-Income Overweight and Obese Pregnant Women

  • Mei-Wei ChangEmail author
  • Roger Brown
  • Susan Nitzke
  • Barbara Smith
  • Kobra Eghtedary


This study investigated the mediating roles of sleep and depression on the relationships between stress, fat intake, and fruit and vegetable intake among low-income overweight and obese pregnant women by trimesters. Participants (N = 213) completed a self-administered survey including stress (exogenous variable), depression, sleep (mediators), fat intake, and fruit and vegetable intake (endogenous variables). Path analysis was performed to compare mediation effects among pregnant women in each trimester. Consistently across three trimesters, stress was related to depression but not sleep duration, night time sleep disturbance, sleep quality, sleep latency or fat intake. Sleep duration was not associated with depression. Depending on trimester, night time sleep disturbance, sleep quality, and sleep latency were related to depression; night time sleep disturbance and depression affected fat intake; stress influenced fruit and vegetable intake. Sleep duration, sleep disturbance, sleep quality, sleep latency and depression did not mediate the relationships between stress, fat intake, and fruit and vegetable intake in the second and third trimesters. However, depression mediated the relationship between stress and fat intake in the first trimester. Stress management interventions may help low-income overweight and obese pregnant women decrease depressive symptoms and therefore contribute to overall nutritional health.


Stress Sleep Depression Pregnant women Low-income Dietary intake 



The study was supported by Clinical and Translational Sciences Institute grant at Michigan State University. We would like to thank Bagya Lakshmi V. Kodur at Michigan Department of Community Health; WIC manager, Diana Buist, and staff at Calhoun County Health Department; WIC supervisor, Deborah Cain, and staff at Genesee County Health Department; WIC staff at Institute of Population Health previously called City of Detroit Department of Health and Wellness Promotion); and WIC manager, Stefanie Horning, and staff at Jackson County Health Department.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mei-Wei Chang
    • 1
    Email author
  • Roger Brown
    • 2
  • Susan Nitzke
    • 3
  • Barbara Smith
    • 1
  • Kobra Eghtedary
    • 4
  1. 1.College of NursingMichigan State UniversityEast LansingUSA
  2. 2.School of NursingUniversity of Wisconsin-MadisonMadisonUSA
  3. 3.Department of Nutritional SciencesUniversity of Wisconsin-MadisonMadisonUSA
  4. 4.WIC ProgramMichigan Department of Community HealthLansingUSA

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