ReviewObesity and anxiety during pregnancy and postpartum: A systematic review

- We review the association between anxiety and obesity during the perinatal period.
- 70% of the included studies reveal a positive association between the two.
- Weight gain prevention in prenatal care could benefit from screening for anxiety.
- None of the included studies examined anxiety disorders according to the DSM.

BackgroundObesity 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.MethodsWe conducted a systematic literature search in PubMed, Web of Science, and PsychINFO.Results13 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.LimitationThe number of included studies is rather small and studies were included irrespective of the study quality which might limit the generalizability of the results.ConclusionsThe 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.