The association between body mass index and postpartum depression: A population-based study
The association between body mass index and postpartum depression: A population-based study
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DOI：
10.1016/j.jad.2018.07.063
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发表时间：
2018-11-01
影响因子：
6.6
通讯作者：
Sandin, Sven
中科院分区：
文献类型：
--
作者：
Silverman, Michael E.;Smith, Lauren;Sandin, Sven
背景：据报道，产后抑郁症（PPD）影响了6.5-19%的新妈妈。确定PPD风险最高的人群对预防、早期发现和干预具有重要意义。虽然人们经常研究极端体重指数（BMI）和抑郁症之间的关系，但BMI和产后抑郁症之间的关系却鲜为人知。方法：对1997-2008年瑞典所有活产单胎妇女进行前瞻性队列研究。我们计算了与每位女性的BMI和抑郁史相关的PPD的相对风险（RR）。产后抑郁症的诊断是基于产后一年内抑郁症的临床诊断。结果：611,506名妇女获得了妊娠早期BMI测量数据。低BMI (< 18.5) RRadj = 1.52, [95% CI: 1.30-1.78]和高BMI (bbb35) RRadj = 1.23, [95% CI: 1.04-1.45]与PPD风险增加相关。有抑郁史的女性BMI较低时患抑郁症的风险增加（RRadj = 1.51, [95% CI: 1.17-1.95]）。局限性：只分析了第一胎，可能低估了PPD的发病率。来自卫生登记的临床数据对诊断的特异性提供了有限的解决方案，如果妇女不寻求治疗，则不完全敏感。结论：妊娠前三个月BMI与PPD风险相关。抑郁症病史进一步改变了这种风险。虽然低BMI使所有女性都有患产后抑郁症的风险，但超重只会增加没有抑郁史的女性患产后抑郁症的风险。未来的研究应该探索PPD和BMI之间关系的潜在可修改机制，也应该研究极端BMI和/或有抑郁史的孕妇的干预策略。
Background: Postpartum depression (PPD) reportedly affects between 6.5-19% of all new mothers. Identifying those at greatest risk for PPD has implications for prevention, early detection and intervention. While the relationship between extremes of body mass index (BMI) and depression has been frequently studied, the association between BMI and PPD is less understood.Methods: Prospective cohort of all women with live singleton births in Sweden 1997-2008. We calculated the relative risk (RR) for PPD in relation to each woman's BMI and depression history. PPD diagnosis was based on a clinical diagnosis of depression within the first postpartum year.Results: First trimester BMI measurements were available for 611,506 women. Low BMI (< 18.5) RRadj = 1.52, [95% CI: 1.30-1.78] and high BMI (> 35) RRadj = 1.23, [95% CI: 1.04-1.45] were associated with increased PPD risk. Women with a depression history had an increased risk with low BMI (RRadj = 1.51, [95% CI: 1.17-1.95]). Limitations: Only first births were analyzed, potentially underestimating PPD incidence. Clinical data from health registries offers limited resolution regarding the specificity of diagnoses and incomplete sensitivity if women do not seek care.Conclusions: First trimester of pregnancy BMI is associated with PPD risk. This risk is further modified by depression history. While low BMI places all women at risk for PPD, being overweight increases risk of PPD only in women without a history of depression. Future research should explore potentially modifiable mechanisms involved in the relationship between PPD and BMI and should also examine interventional strategies for pregnant women at the extremes of BMI and/or with a depression history.