Obesity and Mental Disorders During Pregnancy and Postpartum: a Systematic Review and Meta-analysis

Overview

Journal Obstet Gynecol

Specialty Gynecology & Obstetrics

Date 2014 May 3

PMID 24785615

Citations 104

Authors

Emma Molyneaux

Lucilla Poston

Sarah Ashurst-Williams

Louise M Howard

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the prevalence and risk of antenatal and postpartum mental disorders among obese and overweight women.

Data Sources: Seven databases (including MEDLINE and ClinicalTrials.gov) were searched from inception to January 7, 2013, in addition to citation tracking, hand searches, and expert recommendations.

Methods Of Study Selection: Studies were eligible if antenatal or postpartum mental disorders were assessed with diagnostic or screening tools among women who were obese or overweight at the start of pregnancy. Of the 4,687 screened articles, 62 met the inclusion criteria for the review. The selected studies included a total of 540,373 women.

Tabulation, Integration, And Results: Unadjusted odds ratios were pooled using random-effects meta-analysis for antenatal depression (n=29), postpartum depression (n=16), and antenatal anxiety (n=10). Obese and overweight women had significantly higher odds of elevated depression symptoms than normal-weight women and higher median prevalence estimates. This was found both during pregnancy (obese odds ratio [OR] 1.43, 95% confidence interval [CI] 1.27-1.61, overweight OR 1.19, 95% CI 1.09-1.31, median prevalence: obese 33.0%, overweight 28.6%, normal-weight 22.6%) and postpartum (obese OR 1.30, 95% CI 1.20-1.42, overweight OR 1.09, 95% CI 1.05-1.13, median prevalence: obese 13.0%, overweight 11.8%, normal-weight 9.9%). Obese women also had higher odds of antenatal anxiety (OR 1.41, 95% CI 1.10-1.80). The few studies identified for postpartum anxiety (n=3), eating disorders (n=2), or serious mental illness (n=2) also suggested increased risk among obese women.

Conclusion: Health care providers should be aware that women who are obese when they become pregnant are more likely to experience elevated antenatal and postpartum depression symptoms than normal-weight women, with intermediate risks for overweight women.

Citing Articles

The Interplay Between Sleep Apnea and Postpartum Depression.

Maniaci A, La Via L, Lentini M, Pecorino B, Chiofalo B, Scibilia G Neurol Int. 2025; 17(2).

PMID: 39997651 PMC: 11858767. DOI: 10.3390/neurolint17020020.

'Some Days Are Not a Good Day to Be a Mum': Exploring Lived Experiences of Guilt and Shame in the Early Postpartum Period.

Jackson L, ODonoghue E, Helm J, Gentilcore R, Hussain A Eur J Investig Health Psychol Educ. 2024; 14(12):3019-3038.

PMID: 39727506 PMC: 11675951. DOI: 10.3390/ejihpe14120198.

Gestational diabetes mellitus and peripartum depression: a longitudinal study of a bidirectional relationship.

Zutic M, Matijas M, Stefulj J, Brekalo M, Nakic Rados S BMC Pregnancy Childbirth. 2024; 24(1):821.

PMID: 39702041 PMC: 11660631. DOI: 10.1186/s12884-024-07046-1.

Prenatal Attachment, Personality, and Depression in High-Risk Pregnancies During Pandemic Emergencies.

Burgio S, Cucinella G, Baglio G, Zaami S, Krysiak R, Kowalcze K Healthcare (Basel). 2024; 12(23).

PMID: 39684981 PMC: 11641562. DOI: 10.3390/healthcare12232359.

Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.

Khadka N, Fassett M, Oyelese Y, Mensah N, Chiu V, Yeh M JAMA Netw Open. 2024; 7(11):e2446486.

PMID: 39565621 PMC: 11579791. DOI: 10.1001/jamanetworkopen.2024.46486.

References

LaCoursiere D, Baksh L, Bloebaum L, Varner M . Maternal body mass index and self-reported postpartum depressive symptoms. Matern Child Health J. 2006; 10(4):385-90. DOI: 10.1007/s10995-006-0075-1. View

Catov J, Abatemarco D, Markovic N, Roberts J . Anxiety and optimism associated with gestational age at birth and fetal growth. Matern Child Health J. 2009; 14(5):758-764. PMC: 2996864. DOI: 10.1007/s10995-009-0513-y. View

Bulik C, Holle A, Hamer R, Berg C, Torgersen L, Magnus P . Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Psychol Med. 2007; 37(8):1109-18. PMC: 2657803. DOI: 10.1017/S0033291707000724. View

Demissie Z, Siega-Riz A, Evenson K, Herring A, Dole N, Gaynes B . Physical activity and depressive symptoms among pregnant women: the PIN3 study. Arch Womens Ment Health. 2010; 14(2):145-57. PMC: 3399732. DOI: 10.1007/s00737-010-0193-z. View

Bowers K, Laughon S, Kim S, Mumford S, Brite J, Kiely M . The association between a medical history of depression and gestational diabetes in a large multi-ethnic cohort in the United States. Paediatr Perinat Epidemiol. 2013; 27(4):323-8. PMC: 4123954. DOI: 10.1111/ppe.12057. View

DiPietro J, Millet S, Costigan K, Gurewitsch E, Caulfield L . Psychosocial influences on weight gain attitudes and behaviors during pregnancy. J Am Diet Assoc. 2003; 103(10):1314-9. DOI: 10.1016/s0002-8223(03)01070-8. View

Ruiz R, Marti C, Pickler R, Murphey C, Wommack J, Brown C . Acculturation, depressive symptoms, estriol, progesterone, and preterm birth in Hispanic women. Arch Womens Ment Health. 2012; 15(1):57-67. PMC: 3342385. DOI: 10.1007/s00737-012-0258-2. View

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

Ibanez G, Charles M, Forhan A, Magnin G, Thiebaugeorges O, Kaminski M . Depression and anxiety in women during pregnancy and neonatal outcome: data from the EDEN mother-child cohort. Early Hum Dev. 2012; 88(8):643-9. DOI: 10.1016/j.earlhumdev.2012.01.014. View

10.

Rallis S, Skouteris H, Wertheim E, Paxton S . Predictors of body image during the first year postpartum:a prospective study. Women Health. 2007; 45(1):87-104. DOI: 10.1300/J013v45n01_06. View

11.

Luppino F, de Wit L, Bouvy P, Stijnen T, Cuijpers P, Penninx B . Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010; 67(3):220-9. DOI: 10.1001/archgenpsychiatry.2010.2. View

12.

Goldstein B, Liu S, Zivkovic N, Schaffer A, Chien L, Blanco C . The burden of obesity among adults with bipolar disorder in the United States. Bipolar Disord. 2011; 13(4):387-95. PMC: 3157038. DOI: 10.1111/j.1399-5618.2011.00932.x. View

13.

da Rocha C, Kac G . High dietary ratio of omega-6 to omega-3 polyunsaturated acids during pregnancy and prevalence of post-partum depression. Matern Child Nutr. 2011; 8(1):36-48. PMC: 6860680. DOI: 10.1111/j.1740-8709.2010.00256.x. View

14.

Li D, Liu L, Odouli R . Presence of depressive symptoms during early pregnancy and the risk of preterm delivery: a prospective cohort study. Hum Reprod. 2008; 24(1):146-53. DOI: 10.1093/humrep/den342. View

15.

Dayan J, Creveuil C, Herlicoviez M, Herbel C, Baranger E, Savoye C . Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol. 2002; 155(4):293-301. DOI: 10.1093/aje/155.4.293. View

16.

Boden R, Lundgren M, Brandt L, Reutfors J, Kieler H . Antipsychotics during pregnancy: relation to fetal and maternal metabolic effects. Arch Gen Psychiatry. 2012; 69(7):715-21. DOI: 10.1001/archgenpsychiatry.2011.1870. View

17.

Christian L, Iams J, Porter K, Glaser R . Epstein-Barr virus reactivation during pregnancy and postpartum: effects of race and racial discrimination. Brain Behav Immun. 2012; 26(8):1280-7. PMC: 3469264. DOI: 10.1016/j.bbi.2012.08.006. View

18.

Qiu C, Sanchez S, Lam N, Garcia P, Williams M . Associations of depression and depressive symptoms with preeclampsia: results from a Peruvian case-control study. BMC Womens Health. 2007; 7:15. PMC: 2148036. DOI: 10.1186/1472-6874-7-15. View

19.

Voegtline K, Costigan K, Kivlighan K, Laudenslager M, Henderson J, DiPietro J . Concurrent levels of maternal salivary cortisol are unrelated to self-reported psychological measures in low-risk pregnant women. Arch Womens Ment Health. 2012; 16(2):101-8. PMC: 3671921. DOI: 10.1007/s00737-012-0321-z. View

20.

Carter A, Baker C, Brownell K . Body mass index, eating attitudes, and symptoms of depression and anxiety in pregnancy and the postpartum period. Psychosom Med. 2000; 62(2):264-70. DOI: 10.1097/00006842-200003000-00019. View