Am J Perinatol 2020; 37(01): 019-024
DOI: 10.1055/s-0039-1693989
SMFM 2019
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Gestational Weight Gain and Postpartum Depression in Women with Class III Obesity

LaMani D. Adkins
1   School of Medicine, Duke University, Durham, North Carolina
,
Ann Tucker
2   Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
,
2   Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
,
Anne M. Siegel
2   Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
,
Emily Reiff
2   Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
,
Haywood L. Brown
3   Department of Obstetrics and Gynecology, University of South Florida Health, Tampa, Florida
,
Sarah K. Dotters-Katz
2   Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

23 May 2019

25 June 2019

Publication Date:
05 August 2019 (online)

Abstract

Objective We investigated the association between gestational weight gain (GWG) and postpartum depression (PPD) in women with class III obesity.

Study Design This is a retrospective cohort of women with body mass index (BMI) ≥ 40 kg/m2 at entry to care, first prenatal visit ≤14 weeks gestation, with singleton, nonanomalous pregnancies who delivered at term from July 2013 to December 2017. Women missing data regarding PPD were excluded. Primary outcome was PPD; classified as Edinburgh Postnatal Depression Scale (EPDS) score >13/30 or provider's report of depression. Participants were classified, according to Institute of Medicine GWG guidelines (11–20 pounds), as either less than 11 pounds (LT11) or at/more than 11 pounds (GT11). Bivariate statistics compared demographics and pregnancy characteristics. Logistic regression used to estimate odds of primary outcome.

Results Of 275 women, 96 (34.9%) gained LT11 and 179 (65.1%) gained GT11 during pregnancy. The rate of PPD was 8.7% (n = 24), 9 (9.4%) in the LT11 group and 15 (8.4%) in the GT11 group (p = 0.82, odds ratio: 1.13, 95% confidence interval [CI]: 0.48, 2.69). When controlling for entry BMI and multiparity, adjusted odds of PPD was 1.07 (95% CI: 0.44, 2.63). No correlation was found between GWG and EPDS.

Conclusion A relationship between GWG and PPD in class III obese women was not found in this cohort.

Note

These data were presented in part as a poster presentation at the Society for Maternal-Fetal Medicine's 39th Annual Pregnancy Meeting in February 2019 in Las Vegas, NV.


 
  • References

  • 1 Depression Among Women|Depression|Reproductive Health|CDC. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/reproductivehealth/depression/index.htm . Published 2017. Accessed July 20, 2018
  • 2 Lovejoy MC, Graczyk PA, O'Hare E, Neuman G. Maternal depression and parenting behavior: a meta-analytic review. Clin Psychol Rev 2000; 20 (05) 561-592
  • 3 Murray L, Halligan S, Cooper P. Postnatal depression and young children's development. In: Handbook of Infant Mental Health. New York: Guilford Publications; 2018: 172
  • 4 Luppino FS, de Wit LM, Bouvy PF. , et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67 (03) 220-229
  • 5 National Institute of Diabetes and Digestive and Kidney Diseases. Overweight & Obesity Statistics. Available at: https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity . Published August 1, 2017. Accessed July 20, 2018
  • 6 Deputy NP, Dub B, Sharma AJ. Prevalence and trends in prepregnancy normal weight—48 states, New York City, and District of Columbia, 2011–2015. Morb Mortal Wkly Rep 2018; 66 (51-52): 1402-1407
  • 7 Carter AS, Baker CW, Brownell KD. Body mass index, eating attitudes, and symptoms of depression and anxiety in pregnancy and the postpartum period. Psychosom Med 2000; 62 (02) 264-270
  • 8 Lacoursiere DY, Baksh L, Bloebaum L, Varner MW. Maternal body mass index and self-reported postpartum depressive symptoms. Matern Child Health J 2006; 10 (04) 385-390
  • 9 LaCoursiere DY, Barrett-Connor E, O'Hara MW, Hutton A, Varner MW. The association between prepregnancy obesity and screening positive for postpartum depression. BJOG 2010; 117 (08) 1011-1018
  • 10 Ertel KA, Huang T, Rifas-Shiman SL. , et al. Perinatal weight and risk of prenatal and postpartum depressive symptoms. Ann Epidemiol 2017; 27 (11) 695-700
  • 11 Cline KM, Decker J. Does weight gain during pregnancy influence postpartum depression?. J Health Psychol 2012; 17 (03) 333-342
  • 12 Lacoursiere DY, Varner M. 92: The association between prepregnancy obesity and postpartum depression, supported by NIH grant R03-HD-048865. Am J Obstet Gynecol 2008; 199 (06) S40
  • 13 Institute of Medicine and National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press; 2010
  • 14 Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150 (06) 782-786
  • 15 Bodnar LM, Wisner KL, Moses-Kolko E, Sit DK, Hanusa BH. Prepregnancy body mass index, gestational weight gain, and the likelihood of major depressive disorder during pregnancy. J Clin Psychiatry 2009; 70 (09) 1290-1296
  • 16 Fox P, Yamaguchi C. Body image change in pregnancy: a comparison of normal weight and overweight primigravidas. Birth 1997; 24 (01) 35-40