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

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.

Evaluation of antenatal risk factors for postpartum depression: a secondary cohort analysis of the cluster-randomised GeliS trial

“…In this context, a possible association between maternal weight and onset of PPD continues to receive increasing awareness, although the evidence remains limited and inconclusive. While some studies have found an association between pre-pregnancy overweight or obesity and PPD [13][14][15][16], others failed to confirm these findings [17,18]. In addition to maternal pre-pregnancy weight status, the role of excessive gestational weight gain (GWG) as a risk factor of adverse maternal outcomes has recently been highlighted [19].…”

“…However, the influence of GWG and excessive GWG on the incidence of PPD has rarely been examined. The current state of research indicates no consistent association between GWG or excessive GWG and PPD [15][16][17][20][21][22]. Most studies evaluating the influence of body weight or GWG on PPD were limited by small sample size and the inability to control for a range of confounding factors, in particularly the history of depressive symptoms during pregnancy.…”

Genetic polymorphisms in neuroendocrine disorder-related candidate genes associated with pre-pregnancy obesity in gestational diabetes mellitus patients by using a stratification approach

“…In contrast, genetic association studies of obesity with the following neuroendocrine disorder-related candidate genes, such as ANO2 (22), HTR2C (23), LHPP (24), NRG1 (25), OXTR (26), RORA (27), SDK2 (22), TEX51 (22) and PLEKHG1 (22) have not been evaluated. It is well known that obesity is closely related to psychiatry symptoms, since a large proportion of individuals with psychiatric symptoms such as depression or anxiety also tend to be obese (28)(29)(30); Similarly, those who are obese are at higher risk of developing depression or anxiety symptoms (28,31,32). In addition, there is increasing support for the notion that obesity is a neuroendocrine disorder in which increased leptin, insulin, glucose, triglycerides, and inflammatory cytokines lead to alterations in hypothalamic pituitary adrenal axis, serotonergic and dopaminergic system, increasing the risk of behavioural and mental health disorders (33)(34)(35).…”