Pregnant women should be recommended nutritional education and vitamin supplementation during routine examinations, according to a recent study published in Revista da Associação Médica Brasileira.
Takeaways
- Weight gain during pregnancy is associated with an increased risk of postpartum depression (PPD), particularly with gains over 15 kg.
- Low ferritin levels, indicative of anemia, were significantly correlated with PPD, emphasizing the need for monitoring and supplementation to support maternal health and reduce PPD risk.
- Nutritional education during pregnancy plays a crucial role in PPD prevention, with patients who received such education showing a significantly lower risk of developing PPD.
- Each kilogram increase in weight during pregnancy corresponds to a 1.206-fold increase in PPD risk, highlighting the importance of weight management strategies during prenatal care.
- Prospective longitudinal studies are recommended to further understand the interplay between weight gain, ferritin levels, nutritional education, and PPD risk.
During pregnancy, multiple physiological, psychological, and social changes occur. This includes postpartum depression (PPD), which can be heightened by psychological changes and the postpartum need for infant care. PPD often leads to adverse child growth and development outcomes, and a depression rate up to 19% has been reported.
Anemia, which impacts over 40% of pregnant women, may also be a psychological risk factor of PPD because of associated irritability, fatigue, depressive symptoms, and apathy. Excessive weight gain is another important factor during pregnancy, leading to self-care issues and increased PPD risk.
Investigators conducted a case-control study to determine the association between anemia and weight gain with pregnancy. Participants included patients giving birth at the Obstetrics and Gynecology Clinic of Ankara Etlik City Hospital from April 2023 to June 2023 with similar characteristics and who applied after birth.
Exclusion criteria included twin births, births by fetal anomalies or intrauterine stillbirths, systemic infections, and psychiatric disorder diagnosis within the past 6 months. PPD risk and severity was determined using the Edinburgh Postpartum Depression Scale (EPDS). Patients were evaluated on a 4-point Likert-type scale from 0 to 3 with 10 total items.
Patients with an EPDS score above 12 were categorized as PPD and referred to a psychologist. Those with a score under 12 were placed into the control group.
Nutrition education was provided to participants at a prenatal pregnancy school. If they wanted, patients could also be referred to a dietitian and receive an individualized diet program. Data about patient demographic, laboratory, and postpartum Edinburgh value characteristics were obtained during follow-up using a 16-parameter questionnaire.
There were 109 participants included in the final analysis. Among patients, an association was reported between weight gain during pregnancy and PPD, as PPD risk increased with weight gain over 15 kg. Patients with PPD had significantly reduced ferritin levels vs controls, with a serum ferritin level of 19 ng/dL or less indicating a need for PPD monitoring.
PPD risk is also increased by weight gain during pregnancy of 28.8% of baseline weight or greater. The risk of PPD was increased 1.206-fold by each 1 kg increase in weight during pregnancy, and 1.104-fold by each 1% increase in weight.
Additionally, the risk of PPD was increased 46.02-fold among patients without nutritional education during pregnancy. A 1.12-fold improved protection from PPD was reported for each 1 ng/dL increase in ferritin during early pregnancy.
These results indicated impacts of wight gain during pregnancy, ferritin levels, and nutritional education on PPD risk. Investigators recommended prospective longitudinal studies be conducted to fully evaluate the population.
Reference
Is postpartum depression related to total weight gain during pregnancy and maternal anemia? Rev Assoc Me. Bras. 2024;70(2). doi:10.1590/1806-9282.20230908
