Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety

Falah‐Hassani, Kobra; Shiri, Rahman; Dennis, Cindy‐Lee

doi:10.1016/j.jad.2016.03.010

Cited by 152 publications

(145 citation statements)

References 35 publications

(41 reference statements)

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“…The pregnancy period with hormonal fluctuations, relationship issues and entering a new role as a mother can be emotionally challenging and stressful [44] which in turn may induce emotional eating [45]. Around 10–15% of women experience postpartum depression [46], which may contribute to weight retention, for example due to eating for relief. In this study the strategy of eating for relief emerged as a mediator not only for emotional or psychological factors but also to relief physical discomfort, hence our choice to call the phenomenon "eating for relief" rather than the commonly used "emotional eating".…”

Section: Discussionmentioning

confidence: 99%

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

et al. 2016

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IntroductionObesity in Sweden has doubled to 14% over the last 20 years. New strategies for treatment and prevention are needed. Excessive gestational weight gain has been found to contribute substantially to obesity, and there is a consistent association between postpartum weight retention and obesity later in life. We aimed to explore what factors women perceive as reasons for having substantial postpartum weight retention, to identify areas for new and improved interventions.MethodsQualitative interview study (semi-structured) using an emergent design. Fifteen women, with a postpartum weight retention ≥ 10 kg, were interviewed by a trained cognitive therapist. Eight women had pre-pregnancy BMI below 30 kg/m2. Interviews were transcribed verbatim and data analysed using inductive manifest content analysis. Salient text passages were extracted, shortened, coded and clustered into categories.ResultsParticipants reported no knowledge of current gestational weight gain recommendations or of risks for adverse pregnancy outcomes with excessive weight gain or postpartum weight retention. Excessive eating emerged as a common strategy to provide relief of psychological, emotional and physical discomfort, such as depression and morning sickness. Women perceived medical staff as being unconcerned about weight, and postpartum weight loss support was scarce or absent. Some women reported eating more due to a belief that breastfeeding would automatically lead to weight loss.ConclusionThere is a need to raise awareness about risks with unhealthy gestational weight development and postpartum weight retention in women of childbearing age. The common strategy to cope with psychological, emotional or physical discomfort by eating is an important factor to target with intervention. The postpartum year is a neglected period where additional follow-up on weight and weight loss support is strongly indicated.

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Section: Discussionmentioning

confidence: 99%

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

et al. 2016

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“…Ignoring anxiety in reproductive women is a serious public health concern because a history of anxiety before or during pregnancy is one of the strongest predictors of later high postpartum anxiety or depression [9,[165][166][167]. Furthermore, postpartum depression is frequently comorbid with anxiety [11,[168][169][170], with the postpartum anxiety often preceding the onset of the depression [171,172]. Thus, detecting and treating anxiety before or soon after parturition could often help prevent postpartum depression.…”

Section: Box 1 Postpartum Anxiety: Overlooked Key Player In Postpartmentioning

confidence: 99%

The Neurobiology of Postpartum Anxiety and Depression

Pawluski¹,

Lonstein²,

Fleming³

2017

Trends in Neurosciences

216

169

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Ten to twenty percent of postpartum women experience anxiety or depressive disorders, which can have detrimental effects on the mother, child, and family. Little is known about the neural correlates of these affective disorders when they occur in mothers, but they do have unique neural profiles during the postpartum period compared with when they occur at other times in a woman's life. Given that the neural systems affected by postpartum anxiety and depression overlap and interact with the systems involved in maternal caregiving behaviors, mother-infant interactions are highly susceptible to disruption. Thus, there is an intricate interplay among maternal mental health, the mother-infant relationship, and the neurobiological mechanisms mediating them that needs to be the focus of future study.

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“…Despite the many well‐documented negative effects of PPD/A on both maternal (Eaton, Armenian, Gallo, Pratt, & Ford, 1996; Joynt, Whellan, & O'Connor, 2003; Musselman, Evans, & Nemeroff, 1998; Norhayati, Hazlina, Asrenee, & Emilin, 2015; O'Hara & McCabe, 2013; Paul, Downs, Schaefer, Beiler, & Weisman, 2013; Yim, Tanner Stapleton, Guardino, Hahn‐Holbrook, & Dunkel Schetter, 2015) and child (Ashman, Dawson, & Panagiotides, 2008; Dawson et al., 2003; Elgar, McGrath, Waschbusch, Stewart, & Curtis, 2004; Glasheen, Richardson, & Fabio, 2010; Goodman & Brand, 2008; Goodman & Tully, 2007; Lundy & Field Jeffrey, 1996; Marchand & Hock, 1998; Stein et al., 2014; Zahn‐Waxler, Iannotti, Cummings, & Denham, 1990) health, the biological and psychosocial mechanisms through which PPD/A develop remain unclear (Deecher, Andree, Sloan, & Schechter, 2008; Pawluski, Lonstein, & Fleming, 2017; Payne, Palmer, & Joffe, 2009; Zonana & Gorman, 2005). Complicating our understanding of these mood disorders is the fact that PPD/A often occur comorbidly, with PPA frequently preceding PPD (Falah‐Hassani, Shiri, & Dennis, 2016; Reck et al., 2008), and there is growing consensus that anxiety may be a feature of PPD (Navarro et al., 2007). Preventive psychological and psychosocial interventions have had limited success in reducing the incidence of PPD/A, thus providing few clues about root causes.…”

Section: Introductionmentioning

confidence: 99%

Perinatal western‐type diet and associated gestational weight gain alter postpartum maternal mood

et al. 2017

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IntroductionThe role of perinatal diet in postpartum maternal mood disorders, including depression and anxiety, remains unclear. We investigated whether perinatal consumption of a Western‐type diet (high in fat and branched‐chain amino acids [BCAA]) and associated gestational weight gain (GWG) cause serotonin dysregulation in the central nervous system (CNS), resulting in postpartum depression and anxiety (PPD/A).MethodsMouse dams were fed one of four diets (high‐fat/high BCAA, low‐fat/high BCAA, high‐fat, and low‐fat) prior to mating and throughout gestation and lactation. Postpartum behavioral assessments were conducted, and plasma and brain tissues assayed. To evaluate potential clinical utility, we conducted preliminary human studies using data from an extant sample of 17 primiparous women with high GWG, comparing across self‐reported postpartum mood symptoms using the Edinburgh Postnatal Depression Scale (EPDS) for percent GWG and plasma amino acid levels.ResultsMouse dams fed the high‐fat/high BCAA diet gained more weight per kcal consumed, and BCAA‐supplemented dams lost weight more slowly postpartum. Dams on BCAA‐supplemented diets exhibited increased PPD/A‐like behavior, decreased dopaminergic function, and decreased plasma tyrosine and histidine levels when assessed on postnatal day (P)8. Preliminary human data showed that GWG accounted for 29% of the variance in EPDS scores. Histidine was also lower in women with higher EPDS scores.ConclusionsThese findings highlight the role of perinatal diet and excess GWG in the development of postpartum mood disorders.

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Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety

Cited by 152 publications

References 35 publications

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

The Neurobiology of Postpartum Anxiety and Depression

Perinatal western‐type diet and associated gestational weight gain alter postpartum maternal mood

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