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

LaMani D. Adkins; Ann Tucker; Luke A. Gatta; Anne M. Siegel; Emily Reiff; Haywood L. Brown; Sarah K. Dotters-Katz

doi:10.1055/s-0039-1693989

American Journal of Perinatology, Table of Contents

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

Authors

LaMani D. Adkins

¹School of Medicine, Duke University, Durham, North Carolina
Ann Tucker

²Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
Luke A. Gatta

²Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
Anne M. Siegel

²Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
Emily Reiff

²Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
Haywood L. Brown

³Department of Obstetrics and Gynecology, University of South Florida Health, Tampa, Florida
Sarah K. Dotters-Katz

²Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina

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.

Keywords

gestational weight gain - obesity - postpartum depression - pregnancy

Full Text

References

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