title: Trajectories of depressive symptoms over 2 years postpartum among overweight or obese women.
abstract: BACKGROUND
  Although depressive symptoms are common postpartum, few studies have followed women beyond 12 months postpartum to investigate changes in the number and severity of these symptoms over time, especially in overweight and obese women. Using two complementary analytical methods, this study aims to identify trajectories of depressive symptoms over 2 years postpartum among overweight or obese mothers, and assess the demographic, socioeconomic, and health covariates for these trajectories.
  
  
  METHODS
  Using longitudinal data from two behavioral intervention studies (Kids and Adults Now!-Defeat Obesity [KAN-DO] and Active Mothers Postpartum (AMP); n = 844), we used latent growth modeling to identify the overall trajectory of depressive symptoms and how it was related to key covariates. Next, we used latent class growth analysis to assess the heterogeneity in the depressive symptom trajectories over time, and thereby, identify subgroups of women with distinct trajectories.
  
  
  RESULTS
  The overall trajectory of depressive symptoms over 2 years postpartum was relatively stable in our sample. However, the presence of three distinct latent class trajectories (stable-low [82.5%], decreasing symptoms [7.3%], and increasing symptoms [10.2%]), identified based on trajectory shape and mean depressive symptom score, supported heterogeneity in depressive symptom trajectories over time. Lower maternal education was related to a higher symptom score, and poorer subjective health status at baseline predicted inclusion in the increasing symptoms trajectory.
  
  
  CONCLUSIONS
  In some overweight or obese mothers, postpartum depressive symptoms do not resolve quickly. Practitioners should be aware of this phenomenon and continue to screen for depression for longer periods of time postpartum.
authors.affiliation: School of Family Life, Brigham Young University, Provo, Utah. Electronic address: chienti_lee@byu.edu.
authors.forename: Chien-Ti
authors.initials: CT
authors.lastname: Lee
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Marissa
authors.initials: M
authors.lastname: Stroo
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Bernard
authors.initials: B
authors.lastname: Fuemmeler
authors.affiliation: Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore.
authors.forename: Rahul
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina; Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore.
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology*; D009765:Obesity / Q000523:psychology*; D050177:Overweight / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012917:Social Adjustment; D012959:Socioeconomic Factors; D013997:Time Factors