Gestational weight gain and postpartum depressive symptoms in high-income women with low and late fertility

Objective

This study aimed to investigate the relationship between GWG and postpartum depressive symptoms among high income women with ‘low and late fertility’, combined into a single category.

Methods

We examined the impact of low and late fertility on GWG, based on pre-pregnancy body mass index (BMI) categories, and postpartum depressive symptoms, tested by the Edinburgh Postnatal Depression Scale (EPDS), in a cohort of 2,561 low-risk puerperae, prior to discharge from the maternity ward of Abano Polyclinic, Abano Terme (Italy). Postpartum depressive symptoms were evaluated separately using EPDS cut-off thresholds of > 9 and > 12, as well as the Anhedonia, Anxiety, and Depression subscales.

Results

The women had a median age of 33.0 years (IQR: 30.0–37.0) and a parity of 1.00 (IQR: 1.00–2.00). A higher prevalence of pre-pregnancy underweight status (8.71 %) was observed compared to obesity (5.19 %). Additionally, 25.15 % of the participants had EPDS total scores > 9, and 10.89 % had scores > 12. Analysis revealed a significant overall association between pre-pregnancy BMI and GWG category (p < 0.001), with 47.30 % classified as having adequate GWG, 24.25 % as inadequate, and 28.43 % as excessive. Finally, GWG was not associated with an increased risk of elevated EPDS total scores (>9 or > 12) or with higher scores on the Anhedonia, Depression, or Anxiety subscales.

Conclusion

In high-income women experiencing a late first pregnancy, the lack of association between abnormal GWG and postpartum psycho-emotional distress may be influenced by a higher prevalence of pre-pregnancy underweight status over obesity.