Prepregnancy Obesity and a Biobehavioral Predictive Model for Postpartum Depression

Abstract

Objective To test a predictive model of the associations among prepregnancy body mass index (BMI), third-trimester biological and behavioral variables, and symptoms of depression at 4 weeks postpartum. Design Secondary data analysis from a longitudinal, biobehavioral repeated measures study of women during the third trimester of pregnancy through 6 months postpartum. Setting Communities surrounding a midwestern and a western U.S. city. Participants Participants were 111 women enrolled in their third trimesters of pregnancy who were studied through 4 weeks postpartum. Methods Whole blood and saliva were used for biological measures, and validated questionnaires were used for behavioral measures. Principal component analysis and path analysis with principal component variables were used to iteratively test the model. Results There were three statistically significant direct effects in the model: the path from prepregnancy BMI to inflammation, the path from prepregnancy BMI to stress, and the path from stress to symptoms of depression at 4 weeks postpartum. Indirect effects of prepregnancy BMI on postpartum depression through intervening variables were not statistically significant, nor was the model-based total effect of prepregnancy BMI on postpartum depression. Conclusion Stress was significantly linked to prepregnancy BMI and postpartum depression. This finding highlights continuing possibilities for improving outcomes for mothers, infants, and families through stress-mitigating preventative strategies.

Use of the Antenatal Risk Questionnaire to Assess Psychosocial Risk Factors Associated with Risk for Postpartum Depression: A Pilot Study

“…Analysis of data revealed a significant association between key psychosocial risk factors, perception of stressful life events over the past month, and symptoms of depression in the third trimester of pregnancy and at 6 weeks postpartum. These findings are consistent with other research in which prenatal symptoms of depression and stress are consistently associated with symptoms of PPD . However, this was a small pilot study using a convenience sample, and caution must be used when interpreting the findings.…”

Postpartum depression symptoms in survey-based research: a structural equation analysis

“…Ertel et al [ 17 ] and LaCoursiere et al [ 18 ] also claimed that there was some evidence regarding pre-pregnancy obesity, which may lead to PPD. This claim was also supported by similar research conducted by Ruyak et al [ 19 ]. Mgonja and Schoening [ 10 ] and Ezzeddin et al [ 20 ] further placed emphasis on the issue by examining factors, aside from obesity, that could lead to the development of PPD; the factor included poor marital relationships, divorce, substance abuse, violence, other mental health diagnoses, low educational levels, unwanted or unexpected pregnancies, complicated labor, and a weak health care support system.…”

Maternal early pregnancy obesity and depressive symptoms during and after pregnancy

“…In a series of smaller scale studies from different countries and ethnic groups, the pattern of findings is more mixed with some reporting associations between overweight and/or obesity and depressive symptoms (Bogaerts et al 2013; Dotlic et al 2014; Mina et al 2015; Nagl et al 2016; Ruhstaller et al 2017; Salehi-Pourmehr et al 2017), others reporting null associations (Ertel et al 2015; Sahrakorpi et al 2017) or associations with even lower levels of depressive symptoms during pregnancy (Ertel et al 2015). In the more recent studies that have focused on depressive symptoms after pregnancy, the pattern of findings is also mixed with other studies reporting associations between overweight and/or obesity and depressive symptoms (Mina et al 2015; Salehi-Pourmehr et al 2017), while other studies report that they are unrelated (Ruyak et al 2016; Sahrakorpi et al 2017).…”

“…None of the studies measured depressive symptoms on multiple occasions throughout pregnancy. In only seven (Rallis et al 2007; Ban et al 2012; Christian et al 2012; Ertel et al 2012; Van Poppel et al 2012; Mina et al 2015; Ruyak et al 2016) of the studies on postpartum depressive symptoms, were depressive symptoms during pregnancy taken into account. As over 40% of women with clinically relevant depressive symptoms during pregnancy continue to suffer from these symptoms after pregnancy (Evans et al 2012), it remains unclear if the effects of obesity on postpartum depressive symptoms reflect continuity of symptoms during pregnancy or if obesity is predictive of the onset of symptomatology after pregnancy.…”