86 - Pre-Pregnancy BMI is Associated with Increased Perceived Stress During Pregnancy and Adverse Pregnancy and Neonatal Outcomes

Poster Number: 86
Publication Number: 86.59

Background: Global rates of obesity and anxiety have increased significantly in the past fifty years, and women of reproductive age are at greatest risk. While previous research has focused on the association between obesity and anxiety and depression, there is a lack of understanding regarding the association between Body Mass Index (BMI) and perceived stress during pregnancy.

Objective: We hypothesized that a greater BMI is associated with increased maternal stress and adverse pregnancy and neonatal outcomes.

Design/Methods: This secondary retrospective analysis of the Kellogg Vitamin D Pregnancy Study included women aged 18–45 who presented to the Medical University of South Carolina obstetric clinics within 14 weeks’ gestation between January 2013–May 2016. Baseline maternal health and sociodemographic information was collected during the first study visit. Birth outcomes and infant parameters were collected at birth. Linear regression analyses were used to show the association between maternal Perceived Stress Scale (PSS-10) scores and maternal and infant characteristics. Logistic regression analyses were used to show factors associated with pregnancy outcomes and maternal PSS-10 scores. Generalized linear mixed effect models were created to measure the relationship between maternal PSS-10 scores and BMI, marital status, race, education, insurance status, planned pregnancy, gestational diabetes, and visit.

Results: Of the 407 original participants, this study included 212 healthy women who completed the PSS-10 at 16, 28, and 36 weeks’ gestation (154 had BMI < 30, 58 had BMI≥30). BMI≥30 was associated with increased PSS-10 scores at each visit (p < 0.05). Women with BMI ≥30 were more likely unmarried, Black/Hispanic, lack a college degree, have Medicaid insurance, and have lower 25(OH)D (p < 0.05). In mixed effect models, increased PSS-10 scores were associated with BMI≥30, unmarried, planned pregnancy, and decreased maternal 25(OH)D. BMI≥30 was associated with lower maternal weight gain, lower maternal 25(OH)D 1 month before delivery, and lower maternal 25(OH)D AUC (p < 0.05). Neonates born to women with BMI≥30 were more likely admitted to higher acuity care, have shorter gestational age, and have lower 25(OH)D (p < 0.05).

Conclusion(s): Pregnant women with BMI≥30 had sociodemographic differences and had greater vitamin D deficiency, perceived stress, and adverse neonatal outcomes. BMI remained a strong predictor of higher neonatal acuity and shorter gestational age. Public health efforts should be directed at effective, sustained treatment to reduce BMI prior to pregnancy.