Maternal healthy lifestyle score and psychological well-being: secondary analyses of the PEARS RCT

BACKGROUND: The associations between lifestyle behaviours and well-being are still poorly understood, particularly in the antenatal period when women are potentially exposed to increased stress and anxiety. Moreover, lifestyle behaviours have often been investigated individually, while a Healthy Lifestyle Score (HLS) comprising low-risk protective lifestyle behaviours can be useful for studying links between overall lifestyle and health and psychosocial outcomes. Therefore, our aim was to study associations between maternal HLS in early and late pregnancy and psychological well-being. We focused on women with overweight and obesity (OWOB), as they may be at higher risk of psychosocial vulnerability. METHODS: Secondary analyses were conducted with data from the PEARS (Pregnancy Exercise And nutrition Research Study) trial, a randomized controlled trial of a diet and exercise lifestyle intervention with smartphone application support to prevent gestational diabetes. HLSs (scored 0-5) based on information about maternal diet (AHEI-P), exercise (MET-minutes), alcohol consumption, smoking, and sleep habits were created for 334 and 289 mothers in early (14-16 weeks gestation) and late pregnancy (28 weeks gestation), respectively. Higher HLSs indicate a healthier overall lifestyle. Correlations and regression analyses examined HLS associations with well-being (WHO-5, scored 0-100) in early and late pregnancy. RESULTS: Mean pregravid BMI was 29.2. Mean well-being score was 56.3 in early and 60.7 in late pregnancy. In early pregnancy, 18% of mothers scored 0-2 on HLS, 35% scored 3, and 47% scored 4-5. In late pregnancy, this was 27%, 34% and 39% respectively. Preliminary results show significant positive associations between HLSs and well-being at both time points (r's ranging between 0.16 and 0.29, all p < 0.05). CONCLUSIONS: Higher adherence to healthy lifestyle behaviours in mothers with OWOB was linked with higher well-being throughout pregnancy. KEY MESSAGES: • Many pregnant women with OWOB do not adhere to a healthy lifestyle. • Well-being and a healthy lifestyle are related throughout pregnancy.