No abstract

To identify (1) the association between pre-pregnancy BMI (PP-BMI) and PPD symptoms, and (2) the association between PP-BMI and PPD symptoms after considering PNC utilization as a moderating variable. Data from the 2004 and 2005 Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed from 15 states. The study design utilized two risk-adjustment approaches. One approach included all women in the dataset and used statistical analyses to risk-adjust for pregnancy risk status, and the other approach, through a sensitivity analysis, modified the design of the study by truncating the sample to include only women with healthy pregnancies. An initial association was seen between obesity and PPD symptoms, and PNC and PPD symptoms in the multivariate analyses. However, the inclusion of case-mix variables into the multivariate models removed these associations. Overall, for both approaches, there was no indication of a moderating effect of PNC utilization. Results also revealed that many of the women were significantly affected by a variety of high-risk maternal morbidity (case-mix) variables. Although PNC is important for the health of mothers and babies, it does not appear to moderate the association of PP-BMI and PPD symptoms. However, since this study revealed associations between several high-risk maternal morbidities (included as case-mix variables), and PPD symptoms, it is recommended that future research further investigate the possible association of these morbidities with PPD symptoms. For practice, it is suggested that PNC providers focus on their patients, and establish suitable interventions accordingly.

Engaging in regular moderate-intensity physical activity has been demonstrated as a successful treatment modality for both major and minor depression and as effective as pharmacologic treatments. However, less is known about the use of antenatal physical activity as a preventive modality for depression during the perinatal period. The objective of the present study was to determine if there is an association between antenatal physical activity and PPD. A cross-sectional study using the 2007-2008 Pregnancy Risk Assessment Monitoring System (PRAMS) data from Colorado and North Carolina (N = 6026) was conducted. PRAMS self-reported data are from a large randomized sample collected by the CDC that assesses maternal demographic, socio-economic, and pre-pregnancy and perinatal behaviors. Multivariable logistic regression was used to examine the relationship between antenatal sedentary behavior and PPD. Upon adjusting for maternal age, education, race, marital status, parity, stress, smoking, drinking, and prenatal care utilization, women who did not engage in antenatal physical activity were 1.34 times more likely to screen positive for PPD than women who exercised 5 or more days per week [OR 1.34; 95% CI: (1.04, 1.74); p = 0.03]. These findings suggest that not engaging in antenatal exercise may be associated with an increase risk of PPD. Further research is warranted to better understand the effects of antenatal sedentary behavior on PPD and the potential use of physical activity as a preventive modality for PPD.

No abstract