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Abstract Background During pregnancy, women`s bodies undergo rapid changes in body weight and body size within a relatively short period of time. Pregnancy may therefore be associated with an increased vulnerability for the development of body image dissatisfaction that has been linked to adverse health outcomes for mother and child. The present study aims to examine changes in body image during pregnancy as well as predictors of body image dissatisfaction. This is the first study using a tailored, multidimensional measure of body image especially developed for the pregnant population. Methods A prospective longitudinal design with a quantitative approach was applied. Healthy pregnant women (N = 222) were assessed using standardized instruments at two time points (T1: 18th-22th week of gestation, T2: 33th-37th week of gestation). The impact of demographic, weight- and health-related, behavioral, and psychological factors assessed at T1 on body image dissatisfaction at T1 and T2 was examined using stepwise linear regression analyses. Results T-tests for paired samples revealed that dissatisfaction with strength-related aspects of body image, dissatisfaction with body parts, and concerns about sexual attractiveness increased significantly from the middle to the end of pregnancy. In contrast, preoccupation with appearance, dissatisfaction with complexion, and prioritization of appearance over function were significantly reduced over time. Stepwise linear regression analyses revealed that factors influencing body image depend on the component of body image investigated. Overall, a low level of self-esteem and a high level of pregnancy-specific worries were risk factors for several components of body image dissatisfaction. Besides these, poor sleep quality, low levels of physical activity, disturbed eating behavior, and higher levels of BMI and weight gain were significant predictors. Conclusions The results highlight the multidimensional nature of body image and show positive as well as negative changes during pregnancy. Overall, modifiable psychological, behavioral, and weight-related factors appear relevant to the extent of body image dissatisfaction.

Abstract Background After delivery, some women experience impairment of their mother-infant bonding (MIB), which can lead to long-term disturbances of the mother-child relationship and the child’s social-emotional development. Little is known about the association between early maternal bonding problems and mothers’ own adverse childhood experiences, even though the hypothesis of the intergenerational transmission of caregiving indicates continuity in parenting quality across generations. Therefore, the current study aimed at examining the relationship between maternal childhood maltreatment and postpartum MIB, controlling for the role of postpartum mental health. Methods From February 2014 to March 2015, 725 women completed self-report measures 2 months postpartum. Maternal childhood maltreatment was assessed with the Childhood Trauma Questionnaire, postpartum depression with the Revised Beck Depression Inventory, postpartum anxiety with the Symptom Checklist-90-Revised, and postpartum MIB with the abridged version of the Postpartum Bonding Questionnaire. Data were analysed using a hierarchical regression analysis. Results Almost 46% of the included women reported at least one type of childhood maltreatment with emotional neglect being most prevalent. 13% displayed at least mild postpartum depressive symptomatology and 20% scored above the 75th percentile for postpartum anxiety. In the final regression model, which explained 29% of variance, higher severity of maternal emotional neglect in childhood, higher levels of postpartum depression and higher education were significantly related to more postpartum MIB impairment. In contrast, higher severity of maternal physical neglect was significantly associated with less postpartum MIB impairment. Conclusions This study is the first to explore the relationship between diverse types of maternal childhood maltreatment and postpartum MIB, adjusting for postpartum mental health. Maternal experiences of emotional neglect and postpartum depressive symptoms could serve as indicators to identify and support mothers with heightened risk for bonding problems, but results need to be validated in longitudinal studies.

Abstract Background This study aimed to provide a German translation of the Body Image in Pregnancy Scale (BIPS) – a measure tailored to pregnancy-specific aspects of body image while being consistent to the multifaceted theoretical framework of body image – and to test its psychometric properties and validity. Methods The English-language original version of the BIPS was translated into German language using a forward-backward translation rationale. Face validity of the items was tested in cognitive interviews (n = 5). An online survey was conducted among 291 pregnant women. After conducting standard item analyses, factorial validity was tested using principal-axis factor analysis (PAF). Convergent and incremental validity with measures of body dissatisfaction (FFB), depression (EPDS), anxiety (GAD-7), self-esteem (RSE), and eating disorder psychopathology (EDE-Q) was tested by bivariate correlations and multiple linear hierarchical regression analyses. Results The PFA revealed a 32 item and 6-factor solution resembling the dimensions preoccupation with appearance, dissatisfaction with strength-related aspects, dissatisfaction with body parts, dissatisfaction with complexion, prioritization of appearance over function, and concerns about sexual attractiveness. Internal consistency on a subscale level was good to excellent (.79 ≤ Cronbach’s α ≤ .91). Consistent with theoretical assumptions, we found significant positive correlations of BIPS-G subscales with depression, anxiety and eating disorder psychopathology and negative correlations of BIPS-G subscales with self-esteem. BIPS-G subscales substantially improved the prediction of depression, anxiety, self-esteem and eating disorder psychopathology over demographic factors and body dissatisfaction (.03 ≤ ΔR2 ≤ .15, all p-values

Abstract Background Pre-pregnancy obesity and postpartum mental disorders are prevalent health risks to both the mother and the offspring. The objective of our study was to examine whether a history of childhood maltreatment is associated with pre-pregnancy obesity and postpartum mental health and whether childhood maltreatment and pre-pregnancy BMI independently predict postpartum mental health. Methods We obtained self-reported data from 741 postpartum women before 16 weeks after delivery (M = 8.1 weeks, SD = 3.2). Childhood sexual, physical, and emotional abuse and physical and emotional neglect were assessed with the Childhood Trauma Questionnaire. Depression and anxiety were assessed using the BDI and SCL-90-R. We conducted logistic regression models adjusted for demographic covariates and co-occurrence of different types of maltreatment. Results 7.6% of the included women entered pregnancy with obesity. Forty-six percent reported any type of childhood maltreatment. 6.4% displayed at least moderate postnatal depressive symptomatology and 20.5% scored above the 75th percentile for postpartum anxiety. Severe physical abuse, moderate emotional abuse and severe physical and emotional neglect were associated with pre-pregnancy obesity. After controlling for the presence of all other types of childhood maltreatment, only severe physical abuse was still predictive for pre-pregnancy obesity (adj.OR = 5.24, 95% CI = 1.15-23.75). Pre-pregnancy obesity was associated with an increased risk of postpartum depression (adj.OR = 2.55, 95% CI = 1.08-6.00) but not with elevated anxiety. Pre-pregnancy obesity and severe childhood sexual abuse independently predicted postpartum depression. After controlling for histories of different types of childhood maltreatment, the association between pre-pregnancy obesity and postpartum depression attenuated to non-significance. Conclusions To our knowledge, this is the first study examining empirical relations between childhood maltreatment, pre-pregnancy BMI and postpartum mental health controlling for the co-occurrence of other maltreatment types. Childhood maltreatment has been found being associated with both pre-pregnancy obesity and impaired postpartum mental health and may at least partly account for the association between pre-pregnancy obesity and postpartum depression. Therefore childhood maltreatment is related to two common risk conditions during pregnancy and postpartum which bear several health risks for the mother and the child, and routine screening for histories of childhood maltreatment among pregnant women is warranted.