296: The association of obesity, body image and postpartum depression

Abstract

D. YVETTE LACOURSIERE, ANN HUTTON, MICHAEL VARNER, University of Utah, Salt Lake City, Utah, University of Utah, Nursing, Salt Lake City, Utah OBJECTIVE: In women of reproductive age, obesity has been associated with numerous medical and obstetric problems including depression. Postpartum depression (PPD) affects 10-15% of all women, especially those with a history of pre-existing depression. This series of correlations suggests an association between obesity and PPD. We set out to quantify the relationship between obesity and postpartum depression and identify potential risk factors unique to obese women. STUDY DESIGN: Using a prospective design with an over-sampling technique, women were enrolled 24-36 hours postpartum. Intake data including demographic, medical, obstetric and psychiatric history, pregnancy stressors and anthropomorphic information was collected. Eight weeks postpartum women were contacted, surveyed and completed the Edinburgh Postnatal Depression Screen (EPDS) and modified Body Shape Questionnaire (BSQ). EPDS 12 was used to define a positive PPD screen. Responses were stratified by maternal BMI and analyzed via Chi-Square, ANOVA and Multiple Logistic Regression Modeling. RESULTS: 1282 women were included in the analysis. PPD increased with extremes of BMI. The percent of women by BMI strata with PPD follows: underweight 18.7%, normal weight 12.7%, overweight 15.9%, class I obesity 17.6%, class II obesity 28.0% and class III obesity 29.4%. (p 0.047). Increasing weight gain during pregnancy increases the risk of PPD in normal and overweight women. Poor body image was associated with obesity and weight gain during pregnancy. After controlling for maternal age, race, parity, stressors, and education, BMI is a risk factor for PPD. At the postpartum visit, only 26.3% of providers addressed weight and 53.7% discussed mood. CONCLUSION: This is the first study to use a validated screening tool to evaluate the risk of PPD by maternal BMI. Women at the extremes of BMI and greater weight gains in pregnancy are at increased risk for PPD. Nearly 30% of women with a BMI Y 35 screen positive for PPD, warranting heightened attention to PPD among obese women.