Leefstijl in de periode tussen twee zwangerschappen: De impact op mentale gezondheid van de moeder en perinatale uitkomsten

Obesity and mental health problems are among the most prevalent problems in perinatal health. A high pre-pregnancy BMI is a known risk factor for excessive gestational weight gain, which in turn increases the likelihood of pregnancy complications. While perinatal lifestyle interventions showed success in managing gestational weight gain, their effects on pregnancy complications remain limited because these interventions start too late and fail to address mental health concerns. Therefore, this PhD project studied the effect of an interpregnancy and pregnancy lifestyle intervention, including nutrition, physical activity and mental well-being, on mental health and perinatal outcomes in women with previous excessive GWG. First, we investigated mental health in terms of depressive symptoms, anxiety, sense of coherence, and quality of life before, during, and after pregnancy, as well as the association with pre-pregnancy BMI, postpartum weight retention and body composition. Subsequently, the effect of the interpregnancy and pregnancy INTER-ACT lifestyle intervention was studied on mental health and pregnancy outcomes in subsequent pregnancy. This PhD project offers valuable findings for the further development and implementation of optimal and timely lifestyle interventions for women with a history of excessive gestational weight gain: 1) high prevalences of mental health problems at 6 weeks postpartum, 2) deterioration of mental health through the first year postpartum and at the start of the next pregnancy, 3) significant relationship between mental health problems and weight and fat percentage, 4) only limited effects of the INTER-ACT lifestyle intervention on mental health and no effect on pregnancy complications, 5) lack of psychosocial or psychological interventions to prevent perinatal mental health problems performed during the preconception period by healthcare providers not initially trained as psychotherapeutic experts. Our results highlight the interpregnancy period as a critical time for initiating intervention strategies to ensure a healthy start to the subsequent pregnancy. Lifestyle interventions benefit from both weight management and psychological well-being. The insights gained from this PhD project provide a solid foundation for further research that should focus on evaluating appropriate psychological interventions for women with previous excessive gestational weight gain.