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  1. Hanieh Salehi Pourmehr1,
  2. Azizeh Farshbafkhalili2,
  3. Fatemeh Mohammadi3,
  4. Jamileh Malakouti4,
  5. Somayyeh Rafiee3,
  6. Mozhgan Abdi3,
  7. Nayyer Jafarilar3
  1. 1PhD by research student of Neurourology-Neuroscience Research Center, MSc in midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
  2. 2PhD in Nutrition, Nursing and Midwifery Faculty of Tabriz University of Medical Sciences, Tabriz, Iran
  3. 3BSc in midwifery, Tabriz University of medical sciences, Tabriz, Iran
  4. 4Instructor of midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.


Background and aims: Anxiety disorders during pregnancy are of great significance. Few studies have examined the association of psychosocial factors, particularly anxiety, with weight retention and obesity postpartum. This study is aimed to investigate the extent to which trimesters of pregnancy and early postpartum anxiety is associated with weight retention 1 year after childbirth.

Methods: Sixty two class 2 & 3 obese (BMI ≥35 kg/m2) and 245 normal weight (BMI 18.5–24.9 kg/m2) pregnant women in first trimester of pregnancy were enrolled after calculation of pre-pregnancy BMI from Dec 2012 to Jan 2016 and reported Anxiety symptoms on Beck Anxiety Inventory Scale (BAI) at 1st, 2nd and 3rd trimesters of pregnancy and 6–8 weeks postpartum. A scores ≤15 were considered as minimal and/or mild anxiety and scores ≥16 as moderate to severe anxiety. Associations between antenatal and postpartum anxiety with risk of substantial weight retention (at least 5 kg) 1 year after childbirth were assessed.

Results: One hundred and fifty two women (78.8%) with normal prepregnancy BMI had not nor had mild anxiety during or after pregnancy, while these amounts were 31 women (67.4%) in obese group. 27 (14.0%) in normal BMI and 9 women (19.6%) in obese group experienced antenatal anxiety only, 4 (2.1%) in normal group and 2(4.3%) in obese group experienced postpartum anxiety only and 10(5.2%) in normal group and 4 women (8.7%) in obese group experienced both antenatal and postpartum depression. In all trimesters of pregnancy and postpartum period obese women had more anxiety than normal BMI group, however it was not statistically significant (p=0.1). At 1 year, participants retained a mean of 2.52 kg (range −10 to 17) in normal BMI group and 18.1% retained at least 5 kg and in obese group slightly decrease was shown: –0.02 kg (range −14 to 12) with 11.1% with retained weight at least 5 kg. Binary logistic regression analyses, after adjustment for weight-related covariates, maternal sociodemographics, and parity, antenatal and postpartum anxiety showed antenatal anxiety, either alone or in combination with postpartum anxiety, was not associated with substantial weight retention (odds ratio (OR): 1.15, 95% confidence interval (CI): 0.07, 19.10).

Conclusion: The relationship of obesity with anxiety during pregnancy and after delivery should be taken into consideration by heath care providers when managing obese pregnant women; not only to investigate its impacts on mood, but also to control the effects of mood on inappropriate consequences of obesity. Moreover identifying the other risk factors for weight retention after birth to prevent obesity and its sequels on women to better decision making in prenatal care guidelines contents are required.

  • Prenatal
  • Anxiety
  • Postpartum
  • Obesity
  • Decision Making.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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