573: Gestational weight gain and postpartum depression in women with class III obesity

Abstract

The link between weight changes during pregnancy and postpartum depression(PPD) has been analyzed in a few small studies, although the relationship remains unclear. We aimed to investigate the association between gestational weight gain(GWG) and PPD in women with class III obesity. Retrospective cohort of women with class III obesity (BMI ≥40) with singleton pregnancies delivering at term from 7/2013-12/2017 at a single tertiary center. Women who missed their postpartum visit within 12 weeks of delivery and those missing information regarding PPD were excluded. Primary outcome was postpartum depression; classified as an Edinburgh Postnatal Depression Scale(EPDS) score >13/30 or provider report of PPD in absence of documented EPDS. Bivariate statistics used to compare demographics, pregnancy & obstetric complications, and neonatal factors of women with gestational weight gain less than the Institute of Medicine(IOM) guidelines(<11lbs) (LT11) with those who gained at or more than IOM guidelines (GT11). Stepwise backward regression used to estimate odds of primary outcome. Correlation between GWG and EPDS was assessed. Of 275 included, 96 (34.9%) gained LT11 and 179 (65.1%) gained GT11. Women who gained LT11 had higher median baseline BMI (46.2 vs 43.2) and be multiparous (both p<0.01). The LT11 cohort had lower median delivery BMI (47.9 vs 45.7), and larger median total weight change (-15 vs 2) (both p<0.01). Other demographic, antepartum, intrapartum, and postpartum complications did not differ (Table 1). The rate of PPD in the study population was 8.7% (n=24); 9 (9.4%) in the LT11 arm and 15 (8.4%) in the GT11 arm (p=0.82, odds ratio (OR) 1.13, 95% confidence interval (95% CI) 0.48, 2.69). When controlling for entry BMI and multiparity, the adjusted odds of PPD was 1.07 (95% CI 0.44, 2.63). No correlation found between GWG and EPDS (Figure 1). Though the presence of pre-pregnancy obesity has been associated with increased risk for postpartum depression, a relationship between gestational weight gain in women with class III obesity and postpartum depression was not found in this cohort.View Large Image Figure ViewerDownload Hi-res image Download (PPT)