Relationship Between Depressive Mood and Maternal Obesity: Implications for Postpartum Depression
Depression in the perinatal period (PND) is common and can have devastating consequences for the mother and child. Obesity and depression have a bidirectional relationship, with each being a causal factor for the other. Here, we review the literature exam
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Feeling fat lasts nine months, but the joy of becoming a mom lasts forever – Nikki Dalton
Abstract Depression in the perinatal period (PND) is common and can have devastating consequences for the mother and child. Obesity and depression have a bidirectional relationship, with each being a causal factor for the other. Here, we review the literature examining the associations S.C. Rogan, MD, PhD () Department of Obstetrics and Gynecology, University of Texas at Galveston, School of Medicine, Chapel Hill, NC, USA J.L. Payne, MD Department of Psychiatry, Johns Hopkins, Baltimore, MD, USA S. Meltzer-Brody, MD, MPH Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA e-mail: [email protected] W. Nicholson, K. Baptiste-Roberts (eds.), Obesity During Pregnancy in Clinical Practice, DOI 10.1007/978-1-4471-2831-1_6, © Springer-Verlag London 2014
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between PND, obesity, and postpartum weight retention. The literature is limited but supports a greater incidence of PND among obese women. Universal screening for PND should be part of comprehensive perinatal care, as identification of PND can lead to referral and treatment. Future work should elucidate markers for both obesity and PND to facilitate early identification and intervention. Keywords Perinatal depression • Antenatal depression • Postpartum depression • Obesity • Overweight • Prepregnancy weight • Weight loss
Key Points • There is a bidirectional relationship between depression and obesity. • It is likely that biological factors, lifestyle changes, and psychosocial factors contribute to both depression and obesity in the perinatal period. • There is modest evidence that obesity and postpartum weight retention increase the risk for postpartum depression. The relationship between obesity and antenatal depression is less clear. • The literature examining the relationship between obesity and perinatal depression has many limitations and more prospective and larger studies are needed.
Perinatal Depression Major depressive disorders occurring during pregnancy and postpartum depression (PPD), collectively known as perinatal depression (PND), have a prevalence of 10–15 % in adult women [1–3] and are associated with significant morbidity to the mother, the newborn, and her family [4–7]. The prevalence of PND is significantly higher than both gestational diabetes
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mellitus and hypertension and incurs significant maternal/ fetal morbidity and mortality. Depression during pregnancy is the single greatest risk factor for PPD [1, 8–11]. The point prevalence of major and minor depression occurring during pregnancy ranges from 8.5 % to 11.0 %, with data suggesting incidence rates of major or minor depression to be approximately 14.5 % [12]. Moreover, it is estimated that more than 60 % of PPD cases begin during pregnancy [8]. The literature consistently documents that maternal PND has multiple adverse consequences including maternal suicide and infanticide
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