Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.
Department of Anesthesia, University of Toronto, Toronto, ON, Canada.
Int J Gynaecol Obstet. 2021 May;153(2):234-238. doi: 10.1002/ijgo.13445. Epub 2020 Dec 22.
To examine the association of gestational weight gain (GWG), categorized according to 2009 IOM guidelines as adequate, inadequate, and excessive, with symptoms of mental disorders perceived by mothers after childbearing as anhedonia, anxiety, and depression, defined by the Edinburgh Postnatal Depression Scale (EPDS). Previous studies indicated that disorders related to GWG are associated with an increased risk of postpartum psychological distress.
A prospective cohort study took place at the Policlinico Abano Terme, Italy, from May 2016 to November 2018.
The sample included 1268 healthy at term puerperae, 557 (43.9%) with adequate, 388 (30.6%) with inadequate, and 323 (25.5%) with excessive GWG. Mean EPDS scores were comparable among inadequate, adequate, and excessive GWG groups. However, mean factor scores for anhedonia and anxiety were significantly higher (P = 0.041 and P = 0.001, ANOVA) in mothers with excessive GWG. Conversely, factor scores for depression were significantly higher (P = 0.008, ANOVA) in mothers with inadequate GWG.
It was found that excessive GWG across an uncomplicated pregnancy is a warning sign of symptoms of anhedonia and anxiety, whereas inadequate GWG is a significant indicator of symptoms of depression. These relationships highlight the potential for interventions directed toward psychosocial support to have beneficial effects upon GWG.
根据 2009 年 IOM 指南将妊娠期体重增加（GWG）分为适当、不足和过多，研究 GWG 与产后母亲出现的精神障碍症状（快感缺乏、焦虑和抑郁）之间的关系，这些症状通过爱丁堡产后抑郁量表（EPDS）来定义。先前的研究表明，与 GWG 相关的疾病与产后心理困扰的风险增加有关。
一项前瞻性队列研究于 2016 年 5 月至 2018 年 11 月在意大利的 Policlinico Abano Terme 进行。
该样本包括 1268 名健康足月产妇，其中 557 名（43.9%）GWG 适当，388 名（30.6%）GWG 不足，323 名（25.5%）GWG 过多。在 GWG 不足、适当和过多的组中，EPDS 的平均评分相当。然而，在 GWG 过多的母亲中，快感缺乏和焦虑的平均因子评分显著较高（P=0.041 和 P=0.001，方差分析）。相反，在 GWG 不足的母亲中，抑郁的因子评分显著较高（P=0.008，方差分析）。
发现复杂妊娠中过多的 GWG 是快感缺乏和焦虑症状的警告信号，而不足的 GWG 是抑郁症状的重要指标。这些关系强调了针对社会心理支持的干预措施可能对 GWG 产生有益影响的潜力。
