Perinatal weight and risk of prenatal and postpartum depressive symptoms

Ann Epidemiol. 2017 Nov;27(11):695-700.e1. doi: 10.1016/j.annepidem.2017.10.007. Epub 2017 Oct 16.

Abstract

Purpose: Prepregnancy obesity and weight changes accompanying pregnancy (gestational weight gain and postpartum weight retention) may be associated with risk of maternal depressive symptoms during pregnancy and in the postpartum. The few studies that have examined these relationships report conflicting findings.

Methods: We studied pregnant (n = 2112) and postpartum (n = 1686) women enrolled in Project Viva. We used self-reported prepregnancy and postpartum weight and measured prenatal weight to calculate prepregnancy body mass index (BMI), gestational weight gain (GWG), and postpartum weight retention at 6 months after birth. We assessed elevated depressive symptoms (EDS) with the Edinburgh Postnatal Depression Scale (≥13 on 0-30 scale) at midpregnancy and 6 months postpartum. We used logistic regression to estimate the odds of prenatal and postpartum EDS in relation to prepregnancy BMI, GWG, and postpartum weight retention.

Results: A total of 214 (10%) participants experienced prenatal EDS and 151 (9%) postpartum EDS. Neither prepregnancy BMI nor GWG was associated with prenatal EDS. Prepregnancy obesity (BMI ≥ 30 kg per m2) was associated with higher odds of postpartum EDS (odds ratio = 1.69, 95% confidence interval, 1.01-2.83) compared to normal prepregnancy weight in a model adjusted for age, race/ethnicity, nativity, education, marital status, household income, parity, pregnancy intention, and smoking.

Conclusions: Prepregnancy obesity is associated with elevated depressive symptoms in the postpartum period. Given the current obesity epidemic in the US and the consequences of perinatal depression, additional prevention and screening efforts in this population may be warranted.

Keywords: Gestational weight gain; Postpartum depression; Postpartum weight retention; Prenatal depression; Prepregnancy BMI.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index
  • Body Weight
  • Depression / diagnosis*
  • Depression / ethnology
  • Depression / psychology*
  • Female
  • Humans
  • Massachusetts / epidemiology
  • Obesity / epidemiology*
  • Overweight / epidemiology
  • Postpartum Period
  • Pregnancy / physiology
  • Pregnancy / psychology*
  • Pregnancy Complications / psychology*
  • Prenatal Care
  • Prospective Studies
  • Young Adult