Obesity and the association with maternal mental health symptoms.
OBJECTIVE
To evaluate the association between maternal obesity and mood disorders including depression, anxiety, stress, and pregnancy-specific stress during pregnancy.


METHODS
This was a planned secondary analysis of a prospective cohort study investigating factors associated with preterm delivery. The cohort included women who initiated prenatal care before 20 weeks with a singleton pregnancy. Maternal mental health was assessed using four standard psychosocial behavioral measures to screen for depression, pregnancy-specific stress, anxiety, and stress. Screen positive scores for each tool were established based on previously published "high" scores.


RESULTS
Of the 1010 women included in the cohort, 355 (35.1%) were obese. There was no significant difference in the number of obese women with stress (64.2% versus 68.4%, p = 0.18), pregnancy-specific stress (26.2% versus 22.1%, p = 0.15), or anxiety (38.6% versus 41.2%, p = 0.42); however, a greater number of obese women did report symptoms consistent with major depression when compared to women with BMIs <30 (30.4% versus 21.2%, p < 0.01).


CONCLUSIONS
Obese women had higher rates of depression in early pregnancy compared to nonobese women. As many of the health behavior interventions for obese women during pregnancy have proven ineffective, incorporating depression screening and treatment into prenatal care may improve perinatal outcomes.
a Department of Obstetrics and Gynecology, Maternal-Child Health Research Program, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
Kelly E
KE
Ruhstaller
a Department of Obstetrics and Gynecology, Maternal-Child Health Research Program, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
Michal A
MA
Elovitz
b Women's Health Nursing, School of Nursing, University of Pennsylvania , Philadelphia, PA , USA.
Marilyn
M
Stringer
c Departments of Psychiatry and Obstetrics and Gynecology, Penn Center for Women's Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, PA , USA.|d Penn Center for Research on Sex and Gender in Health, University of Pennsylvania , Philadelphia, PA , USA.
C Neill
CN
Epperson
a Department of Obstetrics and Gynecology, Maternal-Child Health Research Program, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
Celeste P
CP
Durnwald
D000328:Adult; D015331:Cohort Studies; D003863:Depression; D005260:Female; D006801:Humans; D009765:Obesity / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D055815:Young Adult
Maternal obesity; depression; mental health