Kim Jaewhan, Kelley Joshua, Davidson Lance, Richards Nathan, Adams Ted
Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA.
Department of Exercise Sciences, Brigham Young University, 271 SFH, Provo, UT, 84606, USA.
Obes Surg. 2022 Jun;32(6):1962-1968. doi: 10.1007/s11695-022-06037-5. Epub 2022 Mar 30.
Obesity is a well-known risk factor for depression and mental illnesses. Metabolic and bariatric surgery (MBS) is a common treatment for individuals with severe obesity. Studies suggest that MBS is associated with increased risk of depression. However, little is known if pregnant women following MBS have greater incidence of depression/anxiety than non-surgical pregnant women with severe obesity.
Utah Bariatric Surgery Registry (UBSR) was used to identify subjects who underwent bariatric surgery between 1996 and 2016 and were matched (1:2 matching) to subjects with severe obesity from the Utah Population Database (UPDB). Depression and anxiety diagnoses during pregnancy were identified from birth records and electronic medical records (EMRs) during 10 months before birth. A multivariate logistic regression with clustering due to same subjects with multiple births was used.
Patients included 1427 MBS women (associated 2492 births) and 2854 non-surgical women (associated 4984 births). In the surgical group, 24.4% of the pregnancies had diagnosed depression/anxiety, while 14.3% of the pregnancies in the control group had depression/anxiety (p < 0.01). The surgery group had 1.51 times higher odds of depression and/or anxiety during pregnancy than the control group after controlling for covariates (OR = 1.51, p < 0.01).
The present study provides evidence that women who previously underwent MBS have higher odds of depression/anxiety during pregnancy than women with obesity who did not undergo MBS.
肥胖是抑郁症和精神疾病的一个众所周知的风险因素。代谢和减重手术（MBS）是重度肥胖个体的常见治疗方法。研究表明，MBS与抑郁症风险增加有关。然而，对于接受MBS治疗的孕妇是否比患有重度肥胖的非手术孕妇有更高的抑郁/焦虑发生率，人们知之甚少。
利用犹他州减重手术登记处（UBSR）来识别1996年至2016年间接受减重手术的受试者，并将其与来自犹他州人口数据库（UPDB）的重度肥胖受试者进行匹配（1:2匹配）。通过出生记录和出生前10个月内的电子病历（EMR）确定孕期的抑郁和焦虑诊断。使用了考虑到同一受试者多次分娩的多变量逻辑回归分析。
患者包括1427名接受MBS治疗的女性（涉及2492次分娩）和2854名非手术女性（涉及4984次分娩）。在手术组中，24.4%的妊娠被诊断为抑郁/焦虑，而对照组中这一比例为14.3%（p < 0.01）。在控制协变量后，手术组孕期抑郁和/或焦虑的几率比对照组高1.51倍（OR = 1.51，p < 0.01）。
本研究提供了证据，表明既往接受MBS治疗的女性在孕期发生抑郁/焦虑的几率高于未接受MBS治疗的肥胖女性。
