Pre-pregnancy Body Mass Index and Third-Trimester Depressive Symptoms in a Healthy Privately Insured SampleFunding This work was supported by a grant from the Evergreen Invitational Women's Health Grants Initiative of the Northwestern Memorial Foundation (NMF) to Dr. Massey, grant 5K23DA037913 from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH) to Dr. Massey, and grant K23HD076010 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) of the NIH to Dr. Kominiarek. The NMF, NIDA, NICHD, and NIH had no role in the study design, collection, analysis or interpretation of data, writing of the article, or the decision to submit this article for publication.
23 June 2017
09 December 2017
05 February 2018 (online)
Objectives While being overweight (body mass index [BMI] >25) prior to pregnancy is linked to antenatal depression, whether weight is confounded by socioeconomic and/or medical risks is unclear.
Study Design We assessed 66 healthy privately insured pregnant women at M = 35.0 ± 3.3 weeks for symptoms of depression (Inventory for Depressive Symptoms—Self-Report (IDS-SR 30), lifetime history of depression and other psychiatric conditions (Mini International Neuropsychiatric Interview), and pre-pregnancy BMI derived from pre-pregnancy weight (by recall) and directly measured height. Pre-pregnancy overweight (BMI > 25) and antenatal depression (score of mild or greater  on the IDS-SR 30) were assessed using logistic regression, controlling for past major depressive disorder (MDD) and demographic factors showing significant between group differences.
Results Pre-pregnancy overweight (n = 17; 25.8%) was associated with an increased risk of third trimester depression, independent of past MDD and marital status (odds ratio = 7.47; 95% confidence interval [2.09–26.68]; B (standard error) = 2.010 [0.650]).
Conclusion Replication in a larger sample is suggested to confirm an independent effect of pregravid overweight on third trimester depression.
- 1 Fisher SC, Kim SY, Sharma AJ, Rochat R, Morrow B. Is obesity still increasing among pregnant women? Prepregnancy obesity trends in 20 states, 2003-2009. Prev Med 2013; 56 (06) 372-378
- 2 Ramachenderan J, Bradford J, McLean M. Maternal obesity and pregnancy complications: a review. Aust N Z J Obstet Gynaecol 2008; 48 (03) 228-235
- 3 Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA. Maternal obesity and risk for birth defects. Pediatrics 2003; 111 (5 Pt 2): 1152-1158
- 4 Olivarez SA, Ferres M, Antony K. , et al. Obstructive sleep apnea screening in pregnancy, perinatal outcomes, and impact of maternal obesity. Am J Perinatol 2011; 28 (08) 651-658
- 5 Bodnar LM, Wisner KL, Moses-Kolko E, Sit DK, Hanusa BH. Prepregnancy body mass index, gestational weight gain, and the likelihood of major depressive disorder during pregnancy. J Clin Psychiatry 2009; 70 (09) 1290-1296
- 6 Ashley JM, Harper BD, Arms-Chavez CJ, LoBello SG. Estimated prevalence of antenatal depression in the US population. Arch Women Ment Health 2016; 19 (02) 395-400
- 7 Gentile S. Untreated depression during pregnancy: short- and long-term effects in offspring. A systematic review. Neuroscience 2017; 342: 154-166
- 8 Molyneaux E, Poston L, Ashurst-Williams S, Howard LM. Pre-pregnancy obesity and mental disorders during pregnancy and postpartum: a systematic review and meta-analysis. Pregnancy Hypertens 2014; 4 (03) 236
- 9 Bombard JM, Dietz PM, Galavotti C. , et al. Chronic diseases and related risk factors among low-income mothers. Matern Child Health J 2012; 16 (01) 60-71
- 10 Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010; 202 (01) 5-14
- 11 Skrundz M, Bolten M, Nast I, Hellhammer DH, Meinlschmidt G. Plasma oxytocin concentration during pregnancy is associated with development of postpartum depression. Neuropsychopharmacology 2011; 36 (09) 1886-1893
- 12 Rush AJ, Gullion CM, Basco MR, Jarrett RB, Trivedi MH. The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychol Med 1996; 26 (03) 477-486
- 13 Rush AJ, Blacker D. Handbook of Psychiatric Measures. Washington, DC: American Psychiatric Publishing; 2008
- 14 Brunoni AR, Benute GR, Fráguas R. , et al. The self-rated Inventory of Depressive Symptomatology for screening prenatal depression. Int J Gynaecol Obstet 2013; 121 (03) 243-246
- 15 Sheehan D, Janavs J, Knapp E, Sheehan M, Baker R. Mini-International Neuropsychiatric Interview Clinician Rated, Version 4.0. Tampa, FL: University of South Florida College of Medicine; 1992
- 16 Luppino FS, de Wit LM, Bouvy PF. , et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67 (03) 220-229
- 17 Molyneaux E, Pasupathy D, Kenny LC. , et al; SCOPE consortium. Socio-economic status influences the relationship between obesity and antenatal depression: data from a prospective cohort study. J Affect Disord 2016; 202: 124-127
- 18 Rich-Edwards JW, Kleinman K, Abrams A. , et al. Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. J Epidemiol Community Health 2006; 60 (03) 221-227
- 19 Castanon N, Lasselin J, Capuron L. Neuropsychiatric comorbidity in obesity: role of inflammatory processes. Front Endocrinol (Lausanne) 2014; 5: 74
- 20 Molica F, Morel S, Kwak BR, Rohner-Jeanrenaud F, Steffens S. Adipokines at the crossroad between obesity and cardiovascular disease. Thromb Haemost 2015; 113 (03) 553-566
- 21 Quante M, Dietrich A, ElKhal A, Tullius SG. Obesity-related immune responses and their impact on surgical outcomes. Int J Obes 2015; 39 (06) 877-883
- 22 Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Ann N Y Acad Sci 2017; 1391 (01) 20-34
- 23 Broussard JL, Van Cauter E. Disturbances of sleep and circadian rhythms: novel risk factors for obesity. Curr Opin Endocrinol Diabetes Obes 2016; 23 (05) 353-359
- 24 Weinberger N-A, Kersting A, Riedel-Heller SG, Luck-Sikorski C. Body dissatisfaction in individuals with obesity compared to normal-weight individuals: a systematic review and meta-analysis. Obes Facts 2016; 9 (06) 424-441
- 25 Mellor R, Chua SC, Boyce P. Antenatal depression: an artefact of sleep disturbance?. Arch Women Ment Health 2014; 17 (04) 291-302
- 26 LaGrotte C, Fernandez-Mendoza J, Calhoun SL, Liao D, Bixler EO, Vgontzas AN. The relative association of obstructive sleep apnea, obesity and excessive daytime sleepiness with incident depression: a longitudinal, population-based study. Int J Obes 2016; 40 (09) 1397-1404