Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China.
School of Public Health, Guizhou Medical University, Guiyang, China.
Front Endocrinol (Lausanne). 2023 Jan 10;13:1058160. doi: 10.3389/fendo.2022.1058160. eCollection 2022.
To investigate the association between pre-pregnancy body mass index (BMI) and gestational depressive phenotypes.
The pregnant women receiving the first prenatal examination (4th -13th week of gestation) in Chongqing Health Center for Women and Children were recruited between February 2020 and September 2021. Depressive phenotypes was assessed by the Patient Health Questionnaire (PHQ-9) and the Symptom Checklist 90 (SCL-90) scale at recruitment. Pre-pregnancy weight and height were self-reported by the participants. Demographic and obstetric characteristics were obtained from the hospital information system. The association between pre-pregnancy BMI and the scores of PHQ-9 or SCL-90 scale was investigated by uni-variate analysis with Kruskal-Wallis test and by multi-variate analysis with linear regression model with adjustment of age, parity, smoking, alcohol consumption, and assisted reproduction. The association between pre-pregnancy BMI and PHQ-9 or SCL-90 diagnosed depressive phenotypes was analyzed by Chi-square test and logistic regression respectively.
A total of 12,099 pregnant women were included, where 100% of them filled out the PHQ-9 scale and 99.6% filled out the SCL-90 scale, and 47.26% and 4.62% of the pregnant women had depressive phenotypes, respectively. Women with higher pre-pregnancy BMI had lower depressive phenotypes scores during pregnancy. Multivariable analysis of the PHQ-9 scale showed that overweight/obese subjects had a higher incidence of depressive phenotypes compared with subjects with normal BMI (OR=0.803, 95% CI [0.723, 0.892]). In a stratified analysis assessed by the PHQ-9, women who were overweight/obese prior to pregnancy were less likely to develop depressive phenotypes during pregnancy than women who were normal weight prior to pregnancy, regardless of whether they were nulliparous (OR=0.795, 95%CI[0.696,0.908]) or multiparous (OR=0.809, 95%CI[0.0.681,0.962]), while in the three age groups of 25-29 years, 30-34 years and ≥35 years, pre-pregnancy overweight/obesity were associated with lower risk of gestational depressive phenotypes. However, analysis of the SCL-90 scale showed no statistical association between depressive symptom and BMI. No substantial interaction was observed between BMI and parity or age.
Increased pre-pregnancy BMI may be associated with reduced risk of gestational depressive phenotypes in Chinese women. Independent studies are warranted to validate the findings of the present study.
探讨孕前体重指数（BMI）与妊娠期抑郁表型的关系。
2020 年 2 月至 2021 年 9 月，在重庆市妇幼保健院接受首次产前检查（妊娠第 4-13 周）的孕妇被纳入研究。在招募时，使用患者健康问卷（PHQ-9）和症状清单 90（SCL-90）量表评估抑郁表型。参与者通过自我报告的方式报告孕前体重和身高。从医院信息系统中获取人口统计学和产科特征。采用 Kruskal-Wallis 检验进行单变量分析，采用线性回归模型进行多变量分析，调整年龄、产次、吸烟、饮酒和辅助生殖，探讨孕前 BMI 与 PHQ-9 或 SCL-90 量表评分的关系。采用卡方检验和 logistic 回归分析孕前 BMI 与 PHQ-9 或 SCL-90 诊断为抑郁表型的关系。
共纳入 12099 名孕妇，100%填写了 PHQ-9 量表，99.6%填写了 SCL-90 量表，分别有 47.26%和 4.62%的孕妇出现抑郁表型。孕前 BMI 较高的孕妇在孕期的抑郁表型评分较低。PHQ-9 量表的多变量分析显示，与正常 BMI 相比，超重/肥胖患者发生抑郁表型的几率更高（OR=0.803，95%CI[0.723，0.892]）。在 PHQ-9 分层分析中，与孕前体重正常的孕妇相比，孕前超重/肥胖的孕妇在孕期发生抑郁表型的可能性更小，无论是否为初产妇（OR=0.795，95%CI[0.696，0.908]）或经产妇（OR=0.809，95%CI[0.0.681，0.962]），而在 25-29 岁、30-34 岁和≥35 岁三个年龄组中，孕前超重/肥胖与妊娠期抑郁表型的风险降低相关。然而，SCL-90 量表分析显示，抑郁症状与 BMI 之间无统计学关联。BMI 与产次或年龄之间未见明显交互作用。
孕前 BMI 的增加可能与中国女性妊娠期抑郁表型的发生风险降低有关。需要进一步的研究来验证本研究的结果。
