Prevalence of Depression in Pregnant Women with Bariatric Surgery History and Associated Factors

Abstract

Objective To analyze the prevalence and factors associated with depressive symptoms among Brazilian pregnant women with history of bariatric surgery (BS). Methods This is a cohort study with 247 women who got pregnant after BS. Based on data collection via Google Form, the recruitment of participants occurred in Facebook groups for 13 months. All of them answered a form with Informed Consent, a general data protocol and the Brazilian version of the Depression, Anxiety and Stress Scale-21. Descriptive and inferential analysis were performed, and a binary logistic regression model was tested to predict the factors associated with depressive symptoms. Results The prevalence of depressive symptoms was 32.8%, noted as being higher in the first (40.6%) and third (34.3%) gestational trimesters. Significative associations were found between depression and marital status (p = 0.000), planned pregnancy (p = 0.001), desired pregnancy (p = 0.004) and psychiatric history (p = 0.000). Women who were not married (odds ratio, OR = 3,38; p = 0.002) and had a psychiatric history (OR = 2.70; p = 0.102) had higher chances of showing depression symptoms; while planned and desired pregnancy showed as protective factors to the symptoms of depression. Conclusion These findings highlight the importance of psychological assistance for pregnant women with history of BS, to prevent development of mental disorders and their outcomes for maternal-child health.

Nutritional Implications of Bariatric Surgery on Pregnancy Management—A Narrative Review of the Literature

“…Women with a history of BS are often afraid of weight regain during pregnancy, and their daily caloric intake is insufficient; therefore, it is crucial to provide them with specialist dietary and psychological care. The importance of psychological assistance is also important because depressive symptoms in pregnant women after BS affect approximately one-third of patients [22]. Hedderson et al presented a telephonic nutritional management program for pregnant women after BS.…”

Medical and Psychological Aspects of Pregnancy in Women with Obesity and after Bariatric Surgery

“…Regardless of the type of bariatric surgery, reports concerning women's mental state during pregnancy are worrying. An increase in the incidence of mental disorders is reported, especially depression [88][89][90] and anxiety [89], as well as an increase in the incidence of self-harm and suicide [9], and a significant proportion of women who consume alcohol (33.5%) and use opioids (28.5%) have also been observed [90]. A significant relationship with depressive symptoms may include marital status, whether the pregnancy was planned and desired, and a history of mental disorders.…”

“…In turn, mental disorders during pregnancy may increase the rates of abortion, hemorrhage, low birth weight, and negative consequences for the child's psychosocial development. In addition, the psychiatric background may result in less adherence to prenatal care and difficulties in the woman's acquisition of self-care habits, and it affects the quality of the mother-child relationship during pregnancy and postpartum, mainly due to its association with postpartum depression [88]. Considering the above facts, screening patients' mental condition after MBS is recommended before, during, and after pregnancy.…”

Maternal and fetal/neonatal outcomes in pregnancy, delivery and postpartum following bariatric surgery and comparison with pregnant women with obesity: a study protocol for a prospective cohort

“…These disorders can negatively impact fetal growth and development, leading to an increased risk of complications such as abortion or preterm labor [ 47 ]. It's crucial to assess and treat symptoms early to reduce negative consequences for maternal and child health [ 50 ].…”

“…However, rapid changes may cause psychological disorders like depression, anxiety, alcoholism, and bulimia nervosa [ 59 ]. Pregnant women who had bariatric surgery are vulnerable to mental disorders during pregnancy, with depression/anxiety rates higher than those without surgery [ 50 ]. Furthermore, Kim et al reported that in the group of pregnant women with a history of bariatric surgery, the rate of depression/anxiety was 24.4%, while this rate was reported as 14.3% inpregnant women with obesity without a history of bariatric surgery [ 60 ].…”