Impact of weight, ferritin, and nutritional education on risk of postpartum depression | Image credit: © Charlie’s – © Charlie’s – Stock.adobe.com.
Pregnant women should be offered nutritional education and vitamin supplementation during routine check-ups, according to a recent study published in . Revista da Associação Médica Brasileira.
Take-out
- Weight gain during pregnancy, especially weight gain >15 kg, is associated with an increased risk of postpartum depression (PPD).
- Decreased ferritin levels, indicative of anemia, are significantly correlated with PPD, highlighting the need for monitoring and supplementation to support maternal health and reduce PPD risk.
- Nutritional education during pregnancy plays an important role in the prevention of PPD, and patients who receive such education have been shown to have a significantly lower risk of developing PPD.
- Each kilogram of weight gain 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 interactions between weight gain, ferritin levels, nutritional education, and PPD risk.
Many physiological, psychological, and social changes occur during pregnancy. This includes postpartum depression (PPD), which can be heightened by psychological changes and the need for postpartum infant care. PPD often has a negative impact on children’s growth and development, with depression rates reported to be up to 19%.
Anemia, which affects more than 40% of pregnant women, may also be a psychological risk factor for PPD due to associated irritability, fatigue, depressive symptoms, and apathy. Excessive weight gain is also an important factor during pregnancy, leading to problems with self-care and increasing her risk of PPD.
Researchers conducted a case-control study to examine the association between anemia and pregnancy-related weight gain. Participants included patients who gave birth at the Obstetrics and Gynecology Clinic of Ankara Etlik Municipal Hospital from April 2023 to June 2023, had similar characteristics, and applied after delivery.
Exclusion criteria included birth of twins, birth due to fetal abnormality or intrauterine stillbirth, systemic infection, and diagnosis of psychiatric disorder within the past 6 months. PPD risk and severity were determined using the Edinburgh Postnatal Depression Scale (EPDS). Patients were evaluated on a 4-point Likert-type scale ranging from 0 to 3 with a total of 10 items.
Patients with an EPDS score >12 were classified as PPD and referred to a psychologist. Those with scores below 12 were placed in the control group.
Nutrition education was provided to participants at a pregnancy school. If desired, patients can also be referred to a nutritionist and receive an individualized dietary program. Data on patient demographics, laboratory values, and postnatal Edinburgh Value characteristics were obtained during follow-up using a 16-parameter questionnaire.
The final analysis included 109 participants. Among patients, an association between weight gain during pregnancy and PPD was reported, as weight gain >15 kg increases the risk of PPD. PPD patients have significantly reduced ferritin levels compared to controls, and serum ferritin levels below 19 ng/dL indicate the need for PPD monitoring.
PPD risk also increases if weight gain during pregnancy is 28.8% or more of baseline weight. The risk of PPD increased 1.206 times for every 1 kg of weight gain during pregnancy and 1.104 times for every 1% weight gain.
Additionally, patients who did not receive nutrition education during pregnancy had a 46.02-fold increased risk of PPD. It was reported that for every 1 ng/dL increase in her ferritin during early pregnancy, her protection from PPD improved by 1.12 times.
These results demonstrate the impact of gestational weight gain, ferritin levels, and nutritional education on PPD risk. The researchers recommended conducting a prospective longitudinal study to fully evaluate the population.
reference
Is postpartum depression associated with total gestational weight gain and maternal anemia? Associate Associate Professor, me. bra. 2024;70(2). doi:10.1590/1806-9282.20230908
