title: Mental disorders in motherhood according to prepregnancy BMI and pregnancy-related weight changes--A Danish cohort study.
abstract: BACKGROUND
  Previous studies have shown an association between prepregnancy BMI and postpartum depression, but little is known about this association beyond one year postpartum and the influence of postpartum weight retention (PPWR).
  
  
  METHODS
  We used data from 70355 mothers from the Danish National Birth Cohort to estimate the associations between maternal prepregnancy BMI and PPWR, respectively, and incident depression/anxiety disorders until six years postpartum. Outcome was depression or anxiety diagnosed clinically or filling a prescription for an antidepressant. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Follow-up started at the day of delivery. For the analysis regarding PPWR, follow-up started six months postpartum.
  
  
  RESULTS
  Underweight, overweight and obesity were associated with depression and/or anxiety disorders when compared to normal-weight, though the associations were attenuated after adjustments (HR 1.24 [95% CI 1.06-1.45], 1.05 [95% CI 0.96-1.15] and 1.07 [95% CI 0.95-1.21] for underweight, overweight and obese, respectively). Compared to mothers who had returned to their prepregnancy BMI, risk of depression/anxiety disorders was increased for mothers, who from prepregnancy to 6 months postpartum experienced either weight loss >1 BMI unit (HR 1.19 [95% CI 1.06-1.25]), weight gain of 2-3 BMI units (HR 1.23 [95% CI 1.08-1.40]), or weight gain of ≥3 BMI units (HR 1.21 [95% CI 1.05-1.40]).
  
  
  CONCLUSIONS
  Causal direction and mechanisms behind the associations are largely unknown.
  
  
  CONCLUSIONS
  Low prepregnancy body weight and postpartum weight gain or loss are associated with occurrence of depression and anxiety disorders.
authors.affiliation: Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark. Electronic address: mette.bliddal@rsyd.dk.
authors.forename: Mette
authors.initials: M
authors.lastname: Bliddal
authors.affiliation: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Anton
authors.initials: A
authors.lastname: Pottegård
authors.affiliation: Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
authors.forename: Helene
authors.initials: H
authors.lastname: Kirkegaard
authors.affiliation: Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
authors.forename: Jørn
authors.initials: J
authors.lastname: Olsen
authors.affiliation: Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.
authors.forename: Jan Stener
authors.initials: JS
authors.lastname: Jørgensen
authors.affiliation: Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark and Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals-Part of Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Thorkild I A
authors.initials: TI
authors.lastname: Sørensen
authors.affiliation: Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
authors.forename: Chunsen
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Nohr
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D019052:Depression, Postpartum / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D012307:Risk Factors; D015430:Weight Gain; D055815:Young Adult
keywords: Body mass index; Depression; Epidemiology; Mental disorders; Postpartum weight retention; Prepregnancy