Depression and Anxiety: Lack of Associations with an Inadequate Diet in a Sample of Pregnant Women with a History of Bariatric Surgery—a Multicenter Prospective Controlled Cohort Study
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Anxiety and depression levels are higher in obese compared to those in normal weight pregnant women. The aims of this study are to examine anxiety and depression in pregnancy following bariatric surgery and to compare with obese pregnant controls considering the dietary intake of polyunsaturated fatty acids (PUFA), folate, and vitamin B12.
Anxiety (State-Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale) were examined in the first (T1) and third (T3) pregnancy trimester in 54 women with bariatric surgery and 25 obese. T1 and T3 dietary intake of PUFA, folate, and vitamin B12 intake was assessed using a 3-day food record. Mixed models with a compound symmetry covariance structure and regression models were applied.
About half of the women with surgery had high state and trait anxiety scores (≥ 40), which did not significantly change during pregnancy. Every 10-kg postoperative weight loss was associated with an increase in T1 state and trait anxiety with respectively 2.7 and 2.3 points. A smoking woman had a 8.6-point higher state anxiety score than a non-smoking woman in T1. In T3, every additional hour of sleep was associated with a decrease in trait anxiety score with 1.59 points. Anxiety and depression scores were not associated with and could not be explained by inadequate PUFAs, folate, and vitamin B12 intakes. Anxiety scores were higher following surgery than those in untreated obesity at both time points.
Pregnancy following bariatric surgery induces high levels of anxiety that are not associated with an inadequate maternal diet.
KeywordsAnxiety Depression Pregnancy Bariatric surgery Obesity Maternal diet
We would like to thank the UCLL students for their contribution in analyzing the dietary data.
RD is recipient of a postdoctoral research grant from the FWO Flanders (2010–2015).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
This study was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 20.van der Ploeg H. Handleiding bij de Zelf-Beoordelings Vragenlijst. Een Nederlandse bewerking van Spielberger State-Trait Anxiety Inventory STAI-DY. In. Lisse, Swets & Zeitlinger B.V. Test Publishers 2000.Google Scholar
- 21.Spielberger C, Gorsuch R, Lushene R. StAI manual for the state-trait anxiety inventory. Palo Alto: Consulting Psychologists Press; 1970.Google Scholar
- 26.European Food Safety Authority (EFSA). Scientific opinion on dietary reference values for cobalamin. EFSA J. 2015;13.Google Scholar
- 27.European Food Safety Authority (EFSA). Scientific opinion on dietary reference values for folat. EFSA J. 2014;12:3893.Google Scholar
- 28.Vandevijvere S, Geelen A, Gonzalez-Gross M, et al. Evaluation of food and nutrient intake assessment using concentration biomarkers in European adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Br J Nutr. 2013;109(04):736–47. https://doi.org/10.1017/S0007114512002012.CrossRefGoogle Scholar
- 34.Tomfohr-Madsen LM, Clayborne ZM, Rouleau CR, et al. Sleeping for two: an open-pilot study of cognitive behavioral therapy for insomnia in pregnancy. Behav Sleep Med. 2016;15:1–17.Google Scholar
- 37.Lee AM, Lam SK, Sze Mun Lau SM, et al. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol. 2007;110(5):1102–12. https://doi.org/10.1097/01.AOG.0000287065.59491.70.CrossRefGoogle Scholar
- 40.Mozurkewich EL, Clinton CM, Chilimigras JL, et al. The Mothers, Omega-3, and Mental Health Study: a double-blind, randomized controlled trial. Am J Obstet Gynecol. 2013;208:313.e311–9.Google Scholar