Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

Abstract

In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child.

Zusammenfassung

In den letzten Jahrzehnten hat sich das Wissen über die kurz- und langfristigen Effekte von gesundheitsschädigenden Verhaltensweisen und Beeinträchtigungen im psychischen Befinden der Schwangeren und deren zugrunde liegenden Mechanismen zunehmend verbessert. Weniger bekannt ist demgegenüber, welche Faktoren aufseiten der Schwangeren diese Risiken begünstigen können. Das Ziel dieses Beitrags ist es, den aktuellen Forschungsstand zu den Folgen eines Nikotin- und Alkoholkonsums, einer Fehlernährung, einer starken Gewichtszunahme bzw. einer Adipositas sowie psychischer Beeinträchtigungen (Depression und Ängste) zusammenzufassen. Darüber hinaus werden Merkmale der schwangeren Frauen bestimmt, die das Auftreten dieser Risiken erhöhen können. Kenntnisse hierzu erleichtern es dem Kliniker, kritische Fälle frühzeitig zu identifizieren und bedarfsgerechte Unterstützungsangebote einzuleiten. Die Literaturdurchsicht hat gezeigt, dass bestimmte Merkmale der Schwangeren (z. B. Merkmale der Paarbeziehung, psychische Belastungen vor dem Einsetzen der Schwangerschaft) sowohl mit verschiedenen gesundheitsschädigenden Verhaltensweisen als auch mit Beeinträchtigungen im psychischen Befinden assoziiert sind. Die betroffenen Frauen weisen dabei zumeist eine Kumulation von psychosozialen Belastungen auf, die bereits vor der Schwangerschaft vorhanden sind, aber auch nach der Geburt des Kindes weiterhin bestehen bleiben können.

Key words

early identification - predictors - risk factors - pregnancy - review

Schlüsselwörter

Früherkennung - Prädiktoren - Risikofaktoren - Schwangerschaft - Übersicht

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