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.

Postpartum Exercise Intervention Targeting Diastasis Recti Abdominis.

To examine the effectiveness of an online, 12-week exercise intervention on diastasis recti abdominis (DRA) width and negatively associated health outcomes (i.e. weight and core function). Non-pregnant women who were 6-24 months postpartum and ≥ 18 years of age completed the study. Participants (n = 8) were randomized to intervention (exercise) or control groups; with the intervention group completing three exercise sessions per week virtually. Both groups completed three surveys at baseline, 6-weeks, and 12-weeks. DRA width was measured with nylon calipers at baseline and 12-weeks. Repeated measures analysis of covariance examined Group x Time changes in width of DRA, core function, and weight at 12-weeks; effect sizes (i.e. Cohen's d) were calculated. An alpha level of 0.05 was used to determine statistical significance. There was a significant Group x Time interaction for two DRA width measurement sites, 2 inches above navel (rest) (p = 0.007, d = 0.67) and 2 inches above navel (active) (p = 0.005, d = 0.69). The Group x Time interaction for weight approached significance (p = 0.06), with a small between group effect size (d = 0.23). The Group x Time interaction for core function was not significant (p = 0.83). Exercise interventions delivered in a virtual setting may be effective for decreasing the severity of DRA in postpartum women. Future research should investigate the impact of similar programs on other aspects of postpartum mental and physical health, activities of daily living, and clinical practice.

Preparing for postpartum: health care provider discussions and predictors of patient satisfaction.

Women's health care providers are trusted sources of patient education during pregnancy and postpartum; however, little is known about discussion prevalence or patient satisfaction. The purposes of this study were to describe patient-provider discussion prevalence and identify demographic and pregnancy-related factors associated with discussion occurrence and satisfaction. An electronic survey was completed by 319 postpartum women who received prenatal care for a singleton pregnancy within the last 12 months in the United States. Participants reported demographic and pregnancy-related information, and occurrence and satisfaction with information shared during prenatal and postpartum health care. Descriptive statistics and odds ratios were calculated. During pregnancy and postpartum, college graduates were more likely to report any discussion (pregnancy: OR = 1.70, 95% C.I. 1.01, 2.86; postpartum: OR = 1.94, 95% C.I. 1.16, 3.25). Participants with gestational diabetes were less likely to report any discussion during pregnancy (OR = 0.43, 95% C.I. 0.20, 0.92). Obese participants were less likely to report any postpartum discussion compared to underweight/normal weight participants (OR = 0.51, 95% C.I. 0.29, 0.89). Within postpartum health care, college graduates (p = .01) and those with a cesarean section (p = .01) reported lower satisfaction; multiparous women reported higher satisfaction (p = .03). Findings highlight potential inequities in clinical practice and risk factors for postpartum anticipatory care satisfaction.

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.