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Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese.
J Midwifery Womens Health 2018; 63(2):178-184JM

Abstract

INTRODUCTION

Obesity is a risk factor for adverse physical health outcomes during pregnancy. Much less is known about the association between obesity and maternal mental health. Evidence suggests that prenatal depression is associated with excessive weight gain during pregnancy and that this relationship may vary according to pregravid body mass index (BMI). Young women may be particularly vulnerable to postpartum depression. The objective of this study is to examine the association between prepregnancy BMI, gestational weight gain, and postpartum depressive symptoms among adolescents.

METHODS

Participants were 505 pregnant adolescents aged 14 to 21 years followed during pregnancy and 6 months postpartum. Data were collected via interviews and medical record abstraction. Multilevel linear mixed models were used to test the association between excessive gestational weight gain as defined by National Academy of Medicine Guidelines and postpartum depressive symptoms measured via the validated Center for Epidemiologic Studies Depression (CES-D) scale. Analyses controlled for sociodemographic factors (maternal age, race, ethnicity, relationship status), health behaviors (nutrition, physical activity), prenatal depressive symptoms, and postpartum weight retention.

RESULTS

Prepregnancy BMI was classified as follows: 11% underweight, 53% healthy weight, 19% overweight, and 18% obese. One-half (50%) of participants exceeded recommended guidelines for gestational weight gain. Adolescents with excessive gestational weight gain who entered pregnancy overweight or obese had significantly higher postpartum depressive symptoms (β, 2.41; SE, 1.06 vs β, 2.58; SE, 1.08, respectively; both P < .05) compared with those with healthy prepregnancy BMI and appropriate gestational weight gain. Adolescents who gained gestational weight within clinically recommended guidelines were not at risk for increased depressive symptoms.

DISCUSSION

Adolescents who enter pregnancy overweight or obese and experience excessive weight gain may be at increased risk for postpartum depressive symptoms. Health care providers should offer preventive interventions during pregnancy and the interconceptional period to support healthy weight gain and safeguard women's mental health.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29569357

Citation

Cunningham, Shayna D., et al. "Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese." Journal of Midwifery & Women's Health, vol. 63, no. 2, 2018, pp. 178-184.
Cunningham SD, Mokshagundam S, Chai H, et al. Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese. J Midwifery Womens Health. 2018;63(2):178-184.
Cunningham, S. D., Mokshagundam, S., Chai, H., Lewis, J. B., Levine, J., Tobin, J. N., & Ickovics, J. R. (2018). Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese. Journal of Midwifery & Women's Health, 63(2), pp. 178-184. doi:10.1111/jmwh.12686.
Cunningham SD, et al. Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese. J Midwifery Womens Health. 2018;63(2):178-184. PubMed PMID: 29569357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese. AU - Cunningham,Shayna D, AU - Mokshagundam,Shilpa, AU - Chai,Hannah, AU - Lewis,Jessica B, AU - Levine,Jessica, AU - Tobin,Jonathan N, AU - Ickovics,Jeannette R, Y1 - 2018/03/23/ PY - 2017/01/20/received PY - 2017/07/13/revised PY - 2017/07/18/accepted PY - 2018/3/24/pubmed PY - 2019/7/16/medline PY - 2018/3/24/entrez KW - adolescent KW - gestational weight gain KW - obesity KW - postpartum depressive symptoms KW - pregnancy SP - 178 EP - 184 JF - Journal of midwifery & women's health JO - J Midwifery Womens Health VL - 63 IS - 2 N2 - INTRODUCTION: Obesity is a risk factor for adverse physical health outcomes during pregnancy. Much less is known about the association between obesity and maternal mental health. Evidence suggests that prenatal depression is associated with excessive weight gain during pregnancy and that this relationship may vary according to pregravid body mass index (BMI). Young women may be particularly vulnerable to postpartum depression. The objective of this study is to examine the association between prepregnancy BMI, gestational weight gain, and postpartum depressive symptoms among adolescents. METHODS: Participants were 505 pregnant adolescents aged 14 to 21 years followed during pregnancy and 6 months postpartum. Data were collected via interviews and medical record abstraction. Multilevel linear mixed models were used to test the association between excessive gestational weight gain as defined by National Academy of Medicine Guidelines and postpartum depressive symptoms measured via the validated Center for Epidemiologic Studies Depression (CES-D) scale. Analyses controlled for sociodemographic factors (maternal age, race, ethnicity, relationship status), health behaviors (nutrition, physical activity), prenatal depressive symptoms, and postpartum weight retention. RESULTS: Prepregnancy BMI was classified as follows: 11% underweight, 53% healthy weight, 19% overweight, and 18% obese. One-half (50%) of participants exceeded recommended guidelines for gestational weight gain. Adolescents with excessive gestational weight gain who entered pregnancy overweight or obese had significantly higher postpartum depressive symptoms (β, 2.41; SE, 1.06 vs β, 2.58; SE, 1.08, respectively; both P < .05) compared with those with healthy prepregnancy BMI and appropriate gestational weight gain. Adolescents who gained gestational weight within clinically recommended guidelines were not at risk for increased depressive symptoms. DISCUSSION: Adolescents who enter pregnancy overweight or obese and experience excessive weight gain may be at increased risk for postpartum depressive symptoms. Health care providers should offer preventive interventions during pregnancy and the interconceptional period to support healthy weight gain and safeguard women's mental health. SN - 1542-2011 UR - https://www.unboundmedicine.com/medline/citation/29569357/Postpartum_Depressive_Symptoms:_Gestational_Weight_Gain_as_a_Risk_Factor_for_Adolescents_Who_Are_Overweight_or_Obese_ L2 - https://doi.org/10.1111/jmwh.12686 DB - PRIME DP - Unbound Medicine ER -