Maternal body mass index and self-reported postpartum depressive symptoms

Objectives: The association between extremes of body mass index (BMI) and depression in women has been documented, yet little is known about the relationship between obesity and postpartum depression (PPD). This study seeks to characterize the association between BMI and PPD. Methods: The 2000-2001 Utah data from Pregnancy Risk Assessment Monitoring System (PRAMS) were used to determine the proportion of women, stratified by prepregnancy body mass index, reporting postpartum depressed mood and stressors during pregnancy. Results: The prevalence of self-reported moderate or greater depressive symptoms was 27.7% (S.E. +/- 2.2) in underweight, 22.8% (+/- 1.2) in normal weight, 24.8% (+/- 2.9) in overweight and 30.8% (+/- 2.5) in obese women. After controlling for marital status and income, normal BMI (19.8-25.9) was associated with the lowest rate of self-reported postpartum depressive symptoms. There was a two-fold increase in self-reported depressive symptoms requiring assistance among overweight and obese women compared to normal weight women (1.53% normal, 2.99% overweight, and 3.10% obese [p < 0.001]). Obese women were significantly more likely to report emotional and traumatic stressors during pregnancy than normal weight women. Conclusion: This population-based survey suggests a potential association between prepregnancy body mass index and self-reported postpartum depressive symptoms. Prospective studies of association between obesity and PPD, with improved diagnostic precision are warranted.