Effect of Anxiety and Depression Trajectories on the Postpartum Body Weight

Abstract

IntroductionAnxiety and depression have become a focus of concern in mood changes among childbearing women. However, less is known regarding how anxiety and depressive symptom changes over time in women underwent an elective cesarean section. This study is aimed to (1) characterize the joint trajectories of anxiety and depressive symptoms, and (2) investigate the effect of the anxiety and depression courses on the subsequent body weight. MethodsA prospective longitudinal study of childbearing women (N = 139) who underwent an elective cesarean section was conducted. Anxiety and depressive symptoms were assessed using the State Anxiety Inventory (SAI) and the Edinburgh Postnatal Depression Scale, respectively, in the third trimester and 1 day, 1 week, and 1 and 6 months postpartum. The structured questionnaires on demographic features, health status, and body mass index (BMI) were completed. Trajectory analyses were conducted using semiparametric group-based modeling. Analysis of covariance and the trend test were applied. ResultsThe mean age of participants was 33.6 years. Most study participants were multiparas (61.9%) and had at least some college education (73.4%). We identified four distinctive joint trajectories of anxiety and depressive symptoms: class 1 (low, 24.9%), class 2 (mild, 42.9%), class 3 (high, 23%), and class 4 (very high, 6.9%). After adjustment for age and parity, the BMIs were significantly different among the trajectories classes (p<0.05). The classes with high and very high anxiety and depressive symptoms showed a trend toward having higher BMI on postpartum 1 day (p=0.05), 1 month (p=0.03) and 6 months (p=0.06) compared with those with low anxiety and depressive symptoms. DiscussionAnxiety and depressive symptoms are prevalent from pregnancy through postpartum. Distinctive patterns of joint anxiety and depression trajectories were identified. Our findings suggest a need for greater attention to continuous assessment of psychological well-being and body weight among women with cesarean delivery. Research supportThis study was supported by a grant (NSC101-2629-H-038-001) from the Ministry of Science and Technology, Taiwan.