Exploring the Impact of Lifestyle on Well-Being Across Pregnancy Stages in Women with Overweight or Obesity: Insights from the PEARS RCT

Objectives:

The relationships between personal lifestyle habits and overall well-being remain inadequately explored, especially during the prenatal phase when women undergo physiological shifts and heightened psychological stress. A healthy lifestyle score (HLS) that incorporates beneficial lifestyle habits may be advantageous for analyzing connections between overall lifestyle and psychological outcomes. This study’s objective was to investigate bidirectional relationships between an HLS and its elements and psychological well-being among pregnant women with overweight/obesity.

Design:

Secondary analysis of data drawn from the PEARS trial.

Methods:

Healthy lifestyle scores (ranging from 0-5) based on maternal dietary intake (AHEI-P), physical exercise (MET-minutes), alcohol intake, smoking habits, and sleep patterns were calculated for 330 and 287 mothers with overweight/obesity in early (14-16 weeks gestation) and late pregnancy (28 weeks gestation), respectively. Psychological well-being was assessed using the WHO-5 well-being index. Cross-lagged path models (both crude and adjusted) evaluated the direction of relationships between lifestyle (composite score/individual components) and well-being at different points in time during pregnancy.

Results:

The average early pregnancy BMI was 29.2 kg/m². The average well-being score was 56.3% in early pregnancy and 60.7% in late pregnancy. Significant autoregressive influences were noted for the HLS, each individual component, and well-being from early to late pregnancy. Well-being exhibited a positive correlation with the HLS, physical activity, and sleep aspects at both time points (during early and/or late pregnancy). Sleep quality and the absence of smoking in early pregnancy predicted enhanced well-being in late pregnancy.

Conclusions:

A generally healthy lifestyle, consistent physical activity, and particularly the duration and quality of sleep are linked to psychological well-being in pregnancy, and should be encouraged during the antenatal period.