There are significant racial/ethnic disparities in the prevalence of postpartum depression. Prior research suggests that the relationships between weight status and depression may vary by race/ethnicity among the general population. However, few studies have investigated whether race/ethnicity moderates the relationships between pregnancy-related weight and postpartum depressive symptoms (PPDS). This study examines the relationships between pregnancy-related weight and maternal PPDS overall and by race/ethnicity.
This study used data from the Early Childhood Longitudinal Study-Birth Cohort (N≈6950). Ordinary least squares and logistic regression were used to examine whether pregnancy-related weight, including preconception obesity and gestational weight gain, were associated with PPDS. Stratified analyses were used to assess whether these relationships varied by race/ethnicity.
Preconception obesity was associated with higher levels of postpartum depressive symptoms (β=1.208, 95% CI 0.995–1.467). In contrast, gestational weight gain adequacy was not associated with PPDS. Among non-Hispanic (NH) whites, preconception obesity was positively associated with PPDS (β=1.016, 95% CI 0.448–1.584). In contrast, among Hispanics, preconception overweight was associated with lower levels of depressive symptoms (β=-0.887, 95% CI -1.580 to -0.195). There were no statistically significant relationships between pregnancy-related weight and PPDS among NH black or Asian women. However, both NH blacks and Asians were significantly more likely to report PPDS compared to NH whites.
Pregnancy-related weight is associated with higher levels of PPDS, but only among NH white women. Addressing preconception weight could help to reduce overall levels of PPDS but doing so might not mitigate racial/ethnic disparities in postpartum mental health.