Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
The Institute of Nutrition and Food Science, Nanjing Medical University, Nanjing 211166, China.
Nutrients. 2024 Oct 30;16(21):3696. doi: 10.3390/nu16213696.
Postpartum depression (PPD) is a common complication after childbirth. Weight misperception can lead to self-esteem issues and mental health problems, especially in women and adolescents. The aim of this study was to investigate the association between weight perception before and during pregnancy and the status of PPD in Southern China.
From October 2021 to November 2023, a multi-stage sampling method was used to recruit 2169 eligible mothers aged 18-49 who had delivered live-born singleton infants within 3 to 180 days postpartum. Anthropometric measurements and face-to-face questionnaire surveys were conducted to collect data. The Kappa test was used to assess the agreement between actual and perceived weight. The generalized linear model incorporating multiplicative interaction analysis was applied to explore the associations among variables.
The prevalence of PPD status was 18.0%. Among women, 35.2% perceived their pre-pregnancy weight (PPW) as abnormal, while 33.1% perceived their gestational weight gain (GWG) as inappropriate. There was poor agreement between maternal actual and perceived PPW/GWG (Kappa = 0.366, < 0.001; Kappa = 0.188, < 0.001), with 27.8% of women misperceiving their PPW and 52.1% misperceiving their GWG. The results of the general linear model indicated that women who perceived their PPW as underweight ( = 0.70, = 0.016) or overweight/obese ( = 0.86, < 0.001), as well as those who perceived their GWG as excessive ( = 0.47, = 0.028) were more likely to exhibit PPD status. The interaction analysis results showed that those who perceived their PPW as underweight and their GWG as insufficient ( = 1.75, = 0.020), as well as those who perceived their PPW as overweight/obese and their GWG as excessive ( = 0.90, = 0.001) had a positive interactive effect on the occurrence of PPD status, while underestimating PPW and GWG may be a protective factor against PPD status ( = -1.03, = 0.037).
These findings support that maternal weight perception plays a role in the development of PPD status. Further improvement is needed in personalized health education for weight management, both prior to and throughout the pregnancy period. This can help women reduce weight anxiety, better understand their body image, and potentially lower the risk of developing PPD.
产后抑郁症（PPD）是分娩后常见的并发症。体重感知错误会导致自尊问题和心理健康问题，尤其是在女性和青少年中。本研究旨在调查中国南方地区孕妇在怀孕前后对体重的感知与 PPD 状况之间的关系。
2021 年 10 月至 2023 年 11 月，采用多阶段抽样方法招募了 2169 名年龄在 18-49 岁之间、产后 3-180 天内分娩单胎活产婴儿的合格产妇。进行人体测量和面对面问卷调查以收集数据。使用 Kappa 检验评估实际体重和感知体重之间的一致性。应用包含乘法交互作用分析的广义线性模型探讨变量之间的关系。
PPD 状况的患病率为 18.0%。在女性中，35.2%的人认为自己的孕前体重（PPW）异常，而 33.1%的人认为自己的孕期体重增加（GWG）不合适。产妇实际体重和感知体重之间的一致性较差（Kappa=0.366，<0.001；Kappa=0.188，<0.001），27.8%的女性错误地认为自己的 PPW，52.1%的女性错误地认为自己的 GWG。一般线性模型的结果表明，认为自己的 PPW 过轻（=0.70，=0.016）或超重/肥胖（=0.86，<0.001）以及认为自己的 GWG 过多（=0.47，=0.028）的女性更有可能出现 PPD 状况。交互作用分析结果表明，那些认为自己的 PPW 过轻且 GWG 不足（=1.75，=0.020）以及那些认为自己的 PPW 超重/肥胖且 GWG 过多（=0.90，=0.001）的女性对 PPD 状况的发生具有正交互作用，而低估 PPW 和 GWG 可能是 PPD 状况的保护因素（=-1.03，=0.037）。
这些发现支持了产妇体重感知在 PPD 状况发展中的作用。需要进一步改进孕期前后的体重管理个性化健康教育。这可以帮助女性减少体重焦虑，更好地了解自己的身体形象，从而降低患 PPD 的风险。
