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Mental disorders in motherhood according to prepregnancy BMI and pregnancy-related weight changes--A Danish cohort study.
J Affect Disord 2015; 183:322-9JA

Abstract

BACKGROUND

Previous studies have shown an association between prepregnancy BMI and postpartum depression, but little is known about this association beyond one year postpartum and the influence of postpartum weight retention (PPWR).

METHODS

We used data from 70355 mothers from the Danish National Birth Cohort to estimate the associations between maternal prepregnancy BMI and PPWR, respectively, and incident depression/anxiety disorders until six years postpartum. Outcome was depression or anxiety diagnosed clinically or filling a prescription for an antidepressant. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Follow-up started at the day of delivery. For the analysis regarding PPWR, follow-up started six months postpartum.

RESULTS

Underweight, overweight and obesity were associated with depression and/or anxiety disorders when compared to normal-weight, though the associations were attenuated after adjustments (HR 1.24 [95% CI 1.06-1.45], 1.05 [95% CI 0.96-1.15] and 1.07 [95% CI 0.95-1.21] for underweight, overweight and obese, respectively). Compared to mothers who had returned to their prepregnancy BMI, risk of depression/anxiety disorders was increased for mothers, who from prepregnancy to 6 months postpartum experienced either weight loss >1 BMI unit (HR 1.19 [95% CI 1.06-1.25]), weight gain of 2-3 BMI units (HR 1.23 [95% CI 1.08-1.40]), or weight gain of ≥3 BMI units (HR 1.21 [95% CI 1.05-1.40]).

LIMITATION

Causal direction and mechanisms behind the associations are largely unknown.

CONCLUSIONS

Low prepregnancy body weight and postpartum weight gain or loss are associated with occurrence of depression and anxiety disorders.

Authors+Show Affiliations

Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark. Electronic address: mette.bliddal@rsyd.dk.Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark and Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals-Part of Copenhagen University Hospital, Copenhagen, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26047960

Citation

Bliddal, Mette, et al. "Mental Disorders in Motherhood According to Prepregnancy BMI and Pregnancy-related Weight changes--A Danish Cohort Study." Journal of Affective Disorders, vol. 183, 2015, pp. 322-9.
Bliddal M, Pottegård A, Kirkegaard H, et al. Mental disorders in motherhood according to prepregnancy BMI and pregnancy-related weight changes--A Danish cohort study. J Affect Disord. 2015;183:322-9.
Bliddal, M., Pottegård, A., Kirkegaard, H., Olsen, J., Jørgensen, J. S., Sørensen, T. I., ... Nohr, E. A. (2015). Mental disorders in motherhood according to prepregnancy BMI and pregnancy-related weight changes--A Danish cohort study. Journal of Affective Disorders, 183, pp. 322-9. doi:10.1016/j.jad.2015.04.053.
Bliddal M, et al. Mental Disorders in Motherhood According to Prepregnancy BMI and Pregnancy-related Weight changes--A Danish Cohort Study. J Affect Disord. 2015 Sep 1;183:322-9. PubMed PMID: 26047960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mental disorders in motherhood according to prepregnancy BMI and pregnancy-related weight changes--A Danish cohort study. AU - Bliddal,Mette, AU - Pottegård,Anton, AU - Kirkegaard,Helene, AU - Olsen,Jørn, AU - Jørgensen,Jan Stener, AU - Sørensen,Thorkild I A, AU - Wu,Chunsen, AU - Nohr,Ellen A, Y1 - 2015/05/22/ PY - 2015/01/20/received PY - 2015/04/29/revised PY - 2015/04/29/accepted PY - 2015/6/7/entrez PY - 2015/6/7/pubmed PY - 2016/1/13/medline KW - Body mass index KW - Depression KW - Epidemiology KW - Mental disorders KW - Postpartum weight retention KW - Prepregnancy SP - 322 EP - 9 JF - Journal of affective disorders JO - J Affect Disord VL - 183 N2 - BACKGROUND: Previous studies have shown an association between prepregnancy BMI and postpartum depression, but little is known about this association beyond one year postpartum and the influence of postpartum weight retention (PPWR). METHODS: We used data from 70355 mothers from the Danish National Birth Cohort to estimate the associations between maternal prepregnancy BMI and PPWR, respectively, and incident depression/anxiety disorders until six years postpartum. Outcome was depression or anxiety diagnosed clinically or filling a prescription for an antidepressant. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Follow-up started at the day of delivery. For the analysis regarding PPWR, follow-up started six months postpartum. RESULTS: Underweight, overweight and obesity were associated with depression and/or anxiety disorders when compared to normal-weight, though the associations were attenuated after adjustments (HR 1.24 [95% CI 1.06-1.45], 1.05 [95% CI 0.96-1.15] and 1.07 [95% CI 0.95-1.21] for underweight, overweight and obese, respectively). Compared to mothers who had returned to their prepregnancy BMI, risk of depression/anxiety disorders was increased for mothers, who from prepregnancy to 6 months postpartum experienced either weight loss >1 BMI unit (HR 1.19 [95% CI 1.06-1.25]), weight gain of 2-3 BMI units (HR 1.23 [95% CI 1.08-1.40]), or weight gain of ≥3 BMI units (HR 1.21 [95% CI 1.05-1.40]). LIMITATION: Causal direction and mechanisms behind the associations are largely unknown. CONCLUSIONS: Low prepregnancy body weight and postpartum weight gain or loss are associated with occurrence of depression and anxiety disorders. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/26047960/Mental_disorders_in_motherhood_according_to_prepregnancy_BMI_and_pregnancy_related_weight_changes__A_Danish_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(15)00286-4 DB - PRIME DP - Unbound Medicine ER -