Department of Psychology and Logopedics,University of Helsinki,Helsinki,Finland.
British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh,Edinburgh,UK.
Psychol Med. 2018 Oct;48(14):2353-2363. doi: 10.1017/S0033291717003889. Epub 2018 Jan 17.
Previous studies have linked maternal obesity with depressive symptoms during and after pregnancy. It remains unknown whether obesity associates with consistently elevated depressive symptoms throughout pregnancy, predicts symptoms postpartum when accounting for antenatal symptoms, and if co-morbid hypertensive and diabetic disorders add to these associations. We addressed these questions in a sample of Finnish women whom we followed during and after pregnancy.
Early pregnancy body mass index, derived from the Finnish Medical Birth Register and hospital records in 3234 PREDO study participants, was categorized into underweight (<18.5 kg/m2), normal weight (18.5-24.99 kg/m2), overweight (25-29.99 kg/m2), and obese (⩾30 kg/m2) groups. The women completed the Center for Epidemiological Studies Depression Scale biweekly during pregnancy, and at 2.4 (s.d. = 1.2) and/or 28.2 (s.d. = 4.2) weeks after pregnancy.
In comparison to normal weight women, overweight, and obese women reported higher levels of depressive symptoms and had higher odds of clinically significant depressive symptoms during (23% and 43%, respectively) and after pregnancy (22% and 36%, respectively). Underweight women had 68% higher odds of clinically significant depressive symptoms after pregnancy. Overweight and obesity also predicted higher depressive symptoms after pregnancy in women not reporting clinically relevant symptomatology during pregnancy. Hypertensive and diabetic disorders did not explain or add to these associations.
Maternal early pregnancy overweight and obesity and depressive symptoms during and after pregnancy are associated. Mental health promotion should be included as an integral part of lifestyle interventions in early pregnancy obesity and extended to benefit also overweight and underweight women.
先前的研究表明，母亲肥胖与怀孕期间和产后的抑郁症状有关。目前尚不清楚肥胖是否与整个怀孕期间持续升高的抑郁症状相关，是否在考虑产前症状的情况下预测产后症状，以及是否合并高血压和糖尿病等并存疾病会增加这些关联。我们在芬兰女性样本中研究了这些问题，这些女性在怀孕期间和产后接受了随访。
在 3234 名 PREDO 研究参与者中，根据芬兰医疗出生登记和医院记录，将早期妊娠体重指数分为体重不足（<18.5 kg/m2）、正常体重（18.5-24.99 kg/m2）、超重（25-29.99 kg/m2）和肥胖（⩾30 kg/m2）组。这些女性在怀孕期间每两周完成一次流行病学研究中心抑郁量表，在产后 2.4（标准差=1.2）和/或 28.2（标准差=4.2）周完成。
与正常体重女性相比，超重和肥胖女性报告的抑郁症状水平更高，在怀孕期间（分别为 23%和 43%）和产后（分别为 22%和 36%）出现临床显著抑郁症状的可能性也更高。产后体重不足女性出现临床显著抑郁症状的可能性要高出 68%。在怀孕期间没有报告临床相关症状的女性中，超重和肥胖也预示着产后抑郁症状的增加。高血压和糖尿病并不能解释或增加这些关联。
母亲早期妊娠超重和肥胖以及怀孕期间和产后的抑郁症状有关。在早期妊娠肥胖中，应将促进心理健康作为生活方式干预的一个组成部分，并且应该将其扩展到超重和体重不足的女性。
