Background: Adverse cardiovascular events during pregnancy (eg, preeclampsia) occur at higher rates among individuals with overweight or obesity (body mass index ≥25 kg/m ² ) and have been associated with postpartum depression. The present study examined whether changes in cardiovascular health (CVH) during the perinatal period, as defined by the American Heart Association's Life's Essential 8 framework, predicted postpartum psychological functioning among individuals with prepregnancy body mass index ≥25 kg/m ² . Methods and Results: Pregnant individuals (N = 226; mean ± SD age = 28.43 ± 5.4 years; mean body mass index = 34.17 ± 7.15 kg/m ² ) were recruited at 12 to 20 weeks of gestation (mean, 15.64 ± 2.45 weeks) for a longitudinal study of health and well‐being. Participants completed ratings of depression and perceived stress and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6 months postpartum. Body mass index and CVH behaviors were used to calculate a composite CVH score at both time points. Linear regression analyses were performed to examine whether change in CVH related to postpartum symptom scores. Because sleep was measured in only a subset of participants (n = 114), analyses were conducted with and without sleep. Improved CVH was associated with lower postpartum depression (β = −0.18, P 0.4). Conclusions: Improvements in CVH from early pregnancy to 6 months postpartum were associated with lower postpartum depressive symptoms and perceived stress but not when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high‐risk individuals.

Evidence suggests higher hedonic hunger (preoccupation with/desire to consume food for pleasure) is associated with greater ultra -processed food (UPF) consumption in non -pregnant individuals with higher, but not lower, self -report impulsivity or delay discounting. The current study tested the association between hedonic hunger and UPF consumption, and the moderating effects of self -report impulsivity and delay discounting, during pregnancy. Individuals ( N = 220) with body mass index (BMI) >= 25 completed the Power of Food Scale, 24-h dietary recalls, and Barratt Impulsiveness Scale -Version 11 in early -mid pregnancy. A subset enrolled in an ancillary study ( n = 143) completed a Delay Discounting Task. Linear regression and moderation models covaried for age, gestational age, pre -pregnancy BMI, and socioeconomic status. The association between hedonic hunger and UPF consumption was nonsignificant ( p = 0.47). Self -report impulsivity was not a significant moderator ( p = 0.11), but delay discounting was ( p = 0.01). Simple slopes analysis revealed a one -unit increase in hedonic hunger was associated with 7% lower UPF intake among participants with lower ( M +1 SD ) delay discounting ( p = 0.01) and 1% higher UPF intake among those with higher ( M -1 SD ) delay discounting ( p = 0.57). Findings contrast those from research with non -pregnant samples and indicate lower delay discounting may serve as a protective factor, associated with reduced UPF consumption at higher levels of hedonic hunger, during pregnancy.

Psychometrically sound measures of disordered eating during pregnancy are needed, particularly for pregnant individuals with body mass index (BMI) ≥ 25, who are at high risk for disordered eating attitudes/behaviors. We previously adapted the Eating Disorder Examination (EDE) for use among pregnant individuals with BMI ≥ 25. This study examined the factor structure of the EDE-Pregnancy Version (EDE-PV) in a community sample of pregnant individuals with BMI ≥ 25. The EDE-PV was administered to 257 pregnant individuals with pre-pregnancy BMI ≥ 25 between 12 and 20 weeks gestation. The EDE-PV factor structure was determined using an exploratory factor analysis with oblique geomin rotation, internal consistency coefficients were calculated, and convergent and discriminant validity of the EDE-PV factors were assessed. An 11-item, two-factor solution produced an acceptable model fit. The subscales did not replicate those of the EDE and were interpreted as Pregnancy Eating and Weight Change Concerns and Pregnancy Shape and Weight Concerns (αs=.67 and .85; ωs=.70 and .85, respectively). These subscales showed small-to-moderate, positive correlations with weight and psychosocial distress measures and differentiated between participants with and without lifetime histories of any eating disorder diagnosis, demonstrating adequate convergent and discriminant validity. The results indicate that the EDE-PV can more reliably identify factors associated with disordered eating attitudes/behaviors among pregnant individuals with BMI ≥ 25 compared to the EDE and support our call for the development and use of new and/or adapted measures to appropriately assess disordered eating during pregnancy.

Background: During the period from pregnancy through the first year postpartum, vulnerable individuals are at elevated risk for the onset or worsening of psychological distress, and accessible (e.g., virtually delivered) mental health interventions are needed. Research suggests that Mindfulness-Based Cognitive Therapy (MBCT) can effectively mitigate psychological distress, although few studies have evaluated MBCT in the perinatal period, and samples have been clinically homogenous. Thus, we have designed and are conducting a pilot trial of virtually delivered MBCT with pregnant individuals experiencing a range of psychological symptoms to assess its feasibility and preliminarily explore its effectiveness. Here, we present the study protocol. Methods: Eligible participants (target N = 70) are ≥18 years with pregnancies between 12 and 30 weeks of gestation. Participants complete a diagnostic interview, self-report symptom ratings, and a computerized cognitive battery assessing self-regulation at the baseline. Participants are then randomized to either MBCT or care as usual. The MBCT intervention involves eight weekly group sessions delivered virtually, with each session focusing on a mindfulness practice followed by group discussion and skill development. Participants in the intervention group are also encouraged to practice mindfulness skills between sessions. Participants in the control condition are provided with information about mindfulness and treatment resources. Baseline measures are repeated following the eight-week intervention period and at three months postpartum. Conclusions: This pilot study is designed to evaluate the feasibility of virtually delivered MBCT and explore group differences in psychological symptoms during the perinatal period, and will lay the foundation for a larger clinical trial focused on optimizing this intervention to improve psychological functioning among diverse pregnant individuals.

Loss of control while eating (LOC) or feeling unable to control the amount or type of food consumed during an eating episode, is the core psychopathology in binge eating disorders. Yet, the impact of LOC on other psychiatric symptoms during pregnancy is not known. This study evaluated the contribution of prenatal LOC to psychological distress and disordered eating attitudes. Pregnant individuals with BMI ≥ 25 (N = 312) recruited for a perinatal health promotion trial self-reported past-month LOC; eating, shape, and weight concerns; prenatal depressive symptoms, anxiety, and stress. Propensity scores were used to reduce bias associated with cross-sectional data. Overall, 34.3% (n = 107) reported LOC. Individuals with prenatal LOC, relative to those without, endorsed more eating disorder symptoms (ps<.001) as well as more symptoms of depression (7.1±0.3 vs. 5.4±4.9) and anxiety (38.1 ± 11.7 vs. 33.4 ± 11.7) and greater perceived stress (25.0 ± 7.9 vs. 22.0±9.9, ps<.001). LOC frequency was associated with significantly more prenatal psychological distress, beyond the effect of other factors that increase the likelihood of LOC. (ps<.005). Among individuals with elevated BMI, prenatal LOC is common and relates to eating disorder and other psychiatric symptoms. Prenatal LOC may represent a behavioral mechanism for improved psychological health.