<p>The Association Between Pre-Pregnancy Body Mass Index, Perinatal Depression and Maternal Vitamin D Status: Findings from an Australian Cohort Study</p>

Abstract

This study aimed to assess the relationship between early-pregnancy Body Mass Index (BMI), perinatal depression risk and maternal vitamin D status. Patients and Methods: A retrospective cohort study from 2013 to 2017 was undertaken involving 16,528 birth events in the Australian Capital Territory. Multivariate binary logistic regression was conducted using the forced entry method. Mediation of the association between maternal early-pregnancy BMI and perinatal depression risk by vitamin D status was also tested. Results: Adjusted logistic regression models found that high maternal early-pregnancy BMI was associated with increased risk of developing perinatal depression (AOR 1.421; 95% CI, 1.191, 1.696) as well as increased odds of being vitamin D deficient (AOR 1.950; 95% CI; 1.735, 2.191). In comparison to women with low perinatal depression risk, women with high perinatal depression risk had increased odds of being vitamin D deficient (AOR 1.321; 95% CI, 1.105, 1.579). Maternal early-pregnancy BMI was a weak significant predictor of perinatal depression risk after including vitamin D as a mediator, consistent with partial mediation, Path C: B=0.016 (95% CI 1.003, 1.030), p= 0.02. Path C´: B=0.014 (95% CI 1.001, 1.028), p= 0.04. Conclusion: In line with current Australian recommendations, women with high earlypregnancy BMI should be screened for both perinatal depression risk and vitamin D deficiency, with referral to relevant support services when indicated.

Maternal Obesity and Perinatal Depression: An Updated Literature Review

“…Of the seven reviewed articles, five studies show an association between some level of pre-pregnancy obesity and either prenatal or postpartum depressive symptoms even after adjusting for common covariates [19,20,[22][23][24]. The remaining two studies did not find a statistically significant association after adjusting for or mediating with other variables [21,25]. The study by Kumpulainen et al showed a significant association between all severities of maternal obesity and increased risk of both prenatal and postpartum depressive symptoms [22].…”

“…Of the seven articles reviewed, three were primary analyses and four were secondary analyses. Two of the primary analyses studies were prospective cohort studies, and one study was a retrospective cross-sectional cohort study [19][20][21]. Of the secondary analyses, three were analyzing prospective cohort studies, and one was an analysis of a randomized controlled trial [22][23][24][25].…”

“…Four of the studies were based out of the United States, although one study based out of the United States used a Norwegian dataset [19,[23][24][25]. The other three articles were based out of Finland, Australia, and the United Kingdom [20][21][22]. The average size of study participants was 9,094 women, ranging from 357 to 39,915 women.…”

“…Three studies used the Center for Epidemiological Studies Depression Scale (CES-D) [22,23,25]. Two studies used the Edinburgh Postnatal Depression Scale (EPDS) [19,21]. One study used the Hopkins Symptom Checklist (SCL-8) [24].…”

“…Timing of the depressive symptom measurement varied. Two studies measured only prenatal depressive symptoms mid-pregnancy [21,23]. The remaining studies measured prenatal and postpartum depressive symptoms [19,20,22,24,25].…”