(1186) Pre-Pregnancy BMI Associated with Increased Perceived Stress During Pregnancy and Adverse Pregnancy and Neonatal Outcomes

Objective: The association between Body Mass Index (BMI) and perceived stress is understudied. We hypothesized that a greater BMI is associated with increased maternal stress and adverse pregnancy and neonatal outcomes.

Study Design: This 2° retrospective analysis of the Kellogg Vitamin D Pregnancy Study included women aged 18–45 who presented to MUSC obstetric clinics within 14 weeks' gestation between January 2013–May 2016. Baseline maternal health and sociodemographic information was collected during first study visit. Birth outcomes and infant parameters were collected at birth. Linear regression analyses used to show association between maternal Perceived Stress Scale (PSS-10) scores and maternal and infant characteristics; and logistic regression analyses used to show factors associated with pregnancy outcomes and maternal PSS-10 scores. Generalized linear mixed effect models 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: 212 women completed PSS-10 at 16, 28, and 36 wks GA and were the basis for these analyses (154 had BMI< 30, 58 had BMI ≥30). BMI≥30 associated with increased PSS-10 scores at each visit (p< 0.05). Women with BMI≥30: more likely unmarried, Black/Hispanic, less college, Medicaid insurance, and lower 25(OH)D (p< 0.05). In mixed effect models, increased PSS-10 scores associated with BMI≥30, unmarried, planned pregnancy, and decreased maternal 25(OH)D. BMI≥30 associated with lower maternal weight gain, lower maternal 25(OH)D 1 month before delivery, and AUC (p< 0.05). Neonates born to women with BMI≥30 were more likely admitted to higher acuity care, had shorter gestational age, and lower 25(OH)D (p< 0.05).

Conclusion: Pregnant women with BMI≥30 had sociodemographic differences and 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.