The Association between Weight-related Variables and Postpartum Depressive Symptoms.

Objectives: Postpartum depressive symptoms (PPDS) are common, and weight-related variables may be risk factors. In this study, we examined associations between weight-related variables and PPDS in postpartum women. Methods: Participants who gave birth within the past 12 months completed an online survey assessing various weight-related variables and PPDS. We examined associations between weight-related variables and PPDS using regression models. Results: Participants (N=315) were 30.1±3.9 years of age and 5.6±3.7 months postpartum. A majority were white (96.2%), married (87.9%), and had a bachelor's degree or higher (70.5%). Having a higher pre-pregnancy body mass index (BMI) and current BMI, lower weight loss at 6 months postpartum, and substantial postpartum weight retention were associated with higher PPDS. There was no relationship between total gestational weight gain, IOM weight gain category, excess weight gain, postpartum weight retention, and pre-pregnancy-to-postpartum change in BMI, and postpartum depressive symptoms. Conclusions: Understanding factors associated with postpartum depressive symptoms can help to develop and implement appropriate screenings/follow-ups and interventions among those at greatest risk. Given the potential connection to PPDS, there is a need for interventions aimed at promoting healthy pre-conception weight and helping women to lose excess pregnancy weight during the postpartum period.

Pre-pregnancy body dissatisfaction and weight-related outcomes and behaviors during pregnancy.

To examine relationships among pre-pregnancy body dissatisfaction (BD) and gestational weight gain (GWG), and related attitudes/behaviors. Pre-pregnancy BD was self-reported in early pregnancy. Weight-related attitudes/behaviors were self-reported and physical activity was objectively measured during pregnancy. Overall, 92% of the women reported BD, with 69% desiring a smaller pre-pregnancy size than their actual pre-pregnancy size. Ideal pre-pregnancy weight was 20.7 ± 28 pounds less than self-reported pre-pregnancy weight. Only weight-control strategies used at 35 weeks were associated with BD (p = 0.008). Pre-pregnancy BD may not predict risk for excess GWG and some weight-related issues during pregnancy.

Associations between prenatal diet quality and gestational weight gain.

BACKGROUND: Improving prenatal diet quality may promote appropriate gestational weight gain (GWG). AIM: To examine relationships between dietary quality in the second and third trimesters of pregnancy and GWG. METHODS: Participants' (n = 41) dietary intake was assessed at 14-20 and 35 weeks gestation via the Automated Self-Administered 24-h recall (ASA-24). Kilocalories and Healthy Eating Index (HEI-2015) scores were calculated and associations with GWG were explored via linear regression. RESULTS: Participants reported consuming 2139 ± 719 and 2085 ± 704 kilocalories at 18 and 35 weeks, respectively. HEI-2015 total scores at 18 (55.6 ±12.6) and 35 weeks gestation (56.6 ± 14.1) indicated a need for improvement. Greens and beans component score at 35 weeks was the only diet quality score associated with GWG. CONCLUSIONS: GWG was not associated with most diet quality indices. However, vegetable intake may help to attenuate GWG. Future research should seek to elucidate relationships between GWG and dietary quality/intake to provide valuable insight for researchers and clinicians.

Examining the Impact of Body Satisfaction and Physical Activity Change on Postpartum Depressive Symptoms.

BACKGROUND: Relationships among moderate to vigorous physical activity (MVPA), body satisfaction, and postpartum depressive symptoms are not well understood. The purpose of this study is to examine the (1) impact of postpartum body satisfaction and changes in MVPA on postpartum depressive symptoms and (2) moderating effect of changes in MVPA over time on the relationship between postpartum body satisfaction and depressive symptoms. METHODS: Participants (N = 269) self-reported body satisfaction, MVPA (prepregnancy through postpartum), and postpartum depressive symptoms. Differences in MVPA at 3 time points (prepregnancy, third trimester, and postpartum) were calculated to create change scores. Main effects and interactions (body satisfaction × MVPA change) were examined using multiple regression. RESULTS: A majority of the sample did not meet MVPA recommendations at all time points. All body satisfaction measures were inversely related to postpartum depressive symptoms (P = .01 to <.001). MVPA change did not predict postpartum depressive symptoms (P = .43-.90) or moderate the relationship between body satisfaction and postpartum depressive symptoms (P = .14-.94). CONCLUSIONS: Given the relationship between postpartum body satisfaction and depressive symptoms, intervention research should include strategies that promote positive postpartum body image; clinicians should consider screening for body dissatisfaction. Although not a predictor or moderator, pregnancy and postpartum MVPA promotion should continue, as it has numerous other benefits.

The Feasibility and Efficacy of a Behavioral Intervention to Promote Appropriate Gestational Weight Gain.

INTRODUCTION: Nearly half of all women gain above gestational weight gain (GWG) recommendations. This study assessed the feasibility and efficacy of a pilot behavioral intervention on GWG and physical activity behaviors. METHODS: Women (n = 45) 14-20 weeks gestation enrolled in a behavioral intervention. Physicians 'prescribed' the intervention to low risk patients. The intervention included self-monitoring, support, and optional walking groups. Process evaluation measures regarding usage and acceptability of study components were obtained. Physical activity was objectively measured at baseline and 35 weeks. The percentage of participants with appropriate GWG was calculated. Control data was obtained from the same clinic where participants were recruited. RESULTS: Overall, the intervention was acceptable to participants; attrition was low (6.7%), weekly contact was high (87%), and self-monitoring was high (Fitbit worn on 82% of intervention weeks; weekly weighing on 81%). Facebook (40% of weeks) and study website use (19%) was low, as was walking group attendance (7% attended a single group). Participants reported a lack of discussions about the study with their physician. Results showed no significant difference between intervention and control participants in the percentage who gained excess weight (p = 0.37). There was a significant decrease in moderate-to-vigorous physical activity in intervention participants (p < 0.0001). DISCUSSION: Continued efforts for promoting physical activity and appropriate GWG are needed. Although acceptable, the intervention was not efficacious. Trainings for, or input from prenatal healthcare providers on how to best encourage and support patients' engagement in healthy behaviors, such as PA, are warranted.