Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA.
J Womens Health (Larchmt). 2021 Jun;30(6):816-828. doi: 10.1089/jwh.2019.8175. Epub 2020 Oct 20.
There are significant racial/ethnic disparities in the prevalence of postpartum depression. Prior research in the general population suggests that weight status is related to depression and that this relationship varies by race/ethnicity. However, few studies have investigated whether race/ethnicity moderates the relationship between pregnancy-related weight and postpartum depressive symptoms (PPDS). The objective of this study is to examine the relationship between pregnancy-related weight and maternal PPDS overall and by race/ethnicity. This study used data from the Early Childhood Longitudinal Study-Birth Cohort ( ≈ 6950). Ordinary least-squares and logistic regression was used to examine whether pregnancy-related weight, including preconception weight status and gestational weight gain (GWG), was associated with PPDS measured using the Center for Epidemiologic Studies-Depression Scale (CES-D). Stratified analyses were used to assess whether these relationships varied by race/ethnicity. Preconception obesity (body mass index [BMI] ≥30 kg/m) was associated with higher levels of PPDS (β = 0.601, 95% confidence interval [CI], 0.149-1.053). GWG adequacy was not associated with PPDS. Among non-Hispanic (NH) whites, preconception obesity was positively associated with PPDS (β = 1.016, 95% CI, 0.448-1.584). In contrast, among Hispanics, preconception overweight (25 kg/m ≤ BMI <30 kg/m) was associated with lower levels of PPDS (β = -0.887, 95% CI, -1.580 to -0.195). There were no statistically significant relationships between pregnancy-related weight and PPDS among NH black or Asian women, but both groups were significantly more likely than NH whites to report PPDS. Whether and how pregnancy-related weight is associated with PPDS varies by race/ethnicity. Addressing preconception weight could help reduce overall levels of PPDS among NH whites but would likely fail to mitigate racial/ethnic disparities in postpartum mental health.
产后抑郁症在不同种族/民族之间存在显著差异。先前在普通人群中的研究表明，体重状况与抑郁有关，而且这种关系因种族/民族而异。然而，很少有研究调查种族/民族是否调节了与怀孕相关的体重与产后抑郁症状（PPDS）之间的关系。本研究旨在总体上以及按种族/民族考察与怀孕相关的体重与产妇 PPDS 的关系。
本研究使用了幼儿纵向研究-出生队列（≈6950）的数据。使用普通最小二乘法和逻辑回归来检验怀孕相关体重（包括孕前体重状况和妊娠体重增加（GWG））是否与使用流行病学研究中心抑郁量表（CES-D）测量的 PPDS 相关。分层分析用于评估这些关系是否因种族/民族而异。
孕前肥胖（BMI≥30kg/m）与较高水平的 PPDS 相关（β=0.601，95%置信区间[CI]，0.149-1.053）。GWG 充足与 PPDS 无关。在非西班牙裔（NH）白人中，孕前肥胖与 PPDS 呈正相关（β=1.016，95%CI，0.448-1.584）。相比之下，在西班牙裔中，孕前超重（25kg/m≤BMI<30kg/m）与较低水平的 PPDS 相关（β=-0.887，95%CI，-1.580 至-0.195）。NH 黑人或亚裔女性与怀孕相关的体重与 PPDS 之间没有统计学上显著的关系，但这两个群体报告 PPDS 的可能性均明显高于 NH 白人。
与怀孕相关的体重与 PPDS 的关系因种族/民族而异。解决孕前体重问题可能有助于降低 NH 白人的总体 PPDS 水平，但可能无法减轻产后心理健康方面的种族/民族差异。
