Introduction: Pregnancy is a period during which women experience physical and psychological changes. The considerable changes can be found in their bodies and weights and they are quickly exposed to being overweight and obesity. On the other hand, few studies have assessed the association of depression with body mass index (BMI). This study explored whether depression and BMI affect each other in pregnancy. It aimed to investigate the correlation between prenatal depression and BMI in pregnant women in Qom.
Methods: This was a descriptive-correlational study conducted on pregnant women referred to health centers in 2016. Participants were selected using multi-stage cluster sampling. Samples of 236 pregnant women were divided into two groups: the second (14-28 weeks) and third (28-40 weeks) trimesters of pregnancy. Height and weight were measured to determine the initial BMI as well as BMI during pregnancy. Demographic information was collected from demographic and obstetric forms. Depression was measured using the Beck Depression Inventory (BDI-II). Data were analyzed using SPSS software and descriptive statistics, t-test, ANOVA, regression analysis and Pearson’s correlation coefficient, significant at P < 0.05.
Results: The results showed BMI in the second trimester to be 48.3% in the normal range, 16.1% overweight, and 30.5% obese. In the third trimester, BMI was 16.9% in the normal range, 34.4% overweight, and 46.6% obese. The rate of depression was 19.5% in the second trimester and 17.8% in the third trimester. Pearson’s correlation test showed that the association between prenatal depression and BMI did not exist in the second trimester (P = 0.499). In the third trimester, there was a significant negative correlation (P = 0.024). Based on regression analysis, among the factors related to BMI (depression, number of family members, gravidity, number of living children, parity, mother’s age, unwanted pregnancy by father, unwanted pregnancy by mother), depression and were are the only predictive factors strongly associated with BMI (P = 0.002 and P = 0.028, respectively).
Conclusions: In our study, there was an inverse correlation between depression and BMI of pregnant women, so that with increase in depression, BMI decreased. According to the different results of the research, further studies should be carried out regarding the effect of depression on BMI in order to be able to provide further assistance to pregnant women.
Staneva AA, Bogossian F, Wittkowski A. The experience of psychological
distress, depression, and anxiety during pregnancy: A meta-
synthesis of qualitative research. Midwifery. 2015;31(6):563-73.
DOI: 10.1016/j.midw.2015.03.015 PMID: 25912511
McPhie S, Skouteris H, Fuller-Tyszkiewicz M, Hill B, Jacka F,
O’Neil A. Relationships between mental health symptoms and
body mass index in women with and without excessive weight gain
during pregnancy. Midwifery. 2015;31(1):138-46. DOI: 10.1016/j.
midw.2014.07.004 PMID: 25086989
Mehta UJ, Siega-Riz AM, Herring AH. Effect of body image on pregnancy
weight gain. Matern Child Health J. 2011;15(3):324-32. DOI:
1007/s10995-010-0578-7 PMID: 20204481
Manyanga T, da Silva DF, Ferraro ZM, Harvey AL, Wilson S, Ockenden
HN, et al. The effects of culture on guideline discordant gestational
weight gain: a systematic review protocol. Syst Rev. 2015;4:145. DOI:
1186/s13643-015-0132-1 PMID: 26527534
Obesity: preventing and managing the global epidemic. Report
of a WHO consultation. World Health Organ Tech Rep Ser.
;894:i-xii, 1-253. PMID: 11234459
Rasmussen KM, Yaktine AL. Weight Gain During Pregnancy: Reexamining
the Guidelines. Washington DC: National Academy of Sciences;
Tabande A, Kashani E. [The relationship between maternal BMI and
weight gain during pregnancy and maternal and neonatal morbidity].
J Gorgan Univ Med Sci. 2007;7(1):60-5.
Murakami M, Ohmichi M, Takahashi T, Shibata A, Fukao A, Morisaki
N, et al. Prepregnancy body mass index as an important predictor of perinatal
outcomes in Japanese. Arch Gynecol Obstet. 2005;271(4):311-5.
DOI: 10.1007/s00404-004-0629-7 PMID: 15185098
Janghorbani M, Amini M, Willett WC, Mehdi Gouya M, Delavari A,
Alikhani S, et al. First nationwide survey of prevalence of overweight,
underweight, and abdominal obesity in Iranian adults. Obesity (Silver
Spring). 2007;15(11):2797-808. DOI: 10.1038/oby.2007.332
World Health Organization. Obesity and over weight 2016 [ June
. Available from: www.who.int/entity/mediacentre/factsheets/
Kelishadi R, Alikhani S, Delavari A, Alaedini F, Safaie A, Hojatzadeh
E. Obesity and associated lifestyle behaviours in Iran: findings
from the First National Non-communicable Disease Risk Factor
Surveillance Survey. Public Health Nutr. 2008;11(3):246-51. DOI:
1017/S1368980007000262 PMID: 17625028
Hosseini M, Jamei N. [Evaluation of maternal BMI and weight
gain during pregnancy and pregnancy outcomes]. Pajoohande.
Hartley E, McPhie S, Skouteris H, Fuller-Tyszkiewicz M, Hill B. Psychosocial
risk factors for excessive gestational weight gain: A systematic
review. Women Birth. 2015;28(4):e99-e109. DOI: 10.1016/j.
wombi.2015.04.004 PMID: 25959883
World Health Organization. Depression 2016 [April 2016]. Available
James Sadock B, Sadock V, Ruiz P. Synopsis of psychiatry behavioral
sciences. 11th ed. New York: Wolters Kluwer; 2015
Kopelman P, Jebb SA, Butland B. Executive summary: Foresight
‘Tackling Obesities: Future Choices’ project. Obes Rev. 2007;8 Suppl
:vi-ix. DOI: 10.1111/j.1467-789X.2007.00344.x PMID: 17316292
Naghavi M, Abolhassani F, Pourmalek F, Jafari N, Moradi Lakeh M,
Eshrati B. [The Burden of Disease and Injury in Iran in the Year 2003].
Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams
Obstetrics translated by Ghazi Jahani B. 24th ed. Tehran: Golban;
Montazeri A, Montazeri J, Omidvari S, Tavoosi M, Hashemi A, Rostami
T. [Depression in Iran: a systematic review of the literature (2000-
]. Payesh. 2013;12(6):567-94.
Pine DS, Cohen P, Brook J, Coplan JD. Psychiatric symptoms in adolescence
as predictors of obesity in early adulthood: a longitudinal
study. Am J Public Health. 1997;87(8):1303-10. PMID: 9279265
Vafaei M, Safaei M, Salehi S. [The level of anxiety and stress and
depression and its correlation with body mass index (BMI) among
nursing students]. Med Sci J Islam Azad Univ Tehran Med Unit.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory
for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
Hosseinisazi F, Poorreza A, Hosseini M, Shojaizade D. [Depression
Saeidi, et al.
Adv Nurs Midwifery
during pregnancy: the need to integrate finding, increasing the participation
of spouses]. J Gorgan Univ Med Sci. 2005;7(1):60-5.
Rajabi G, Karjookasmaei S. [Psychometric Properties of the adequacy
of the Persian version of Beck depression questionnaire - Second
Edition (BDI-II)]. Educ Measure. 2012;10(3):139-57.
Golparvar M, Kamkar M, Rismanchian B. [Relationship between
Overweight with Self – Esteem Depression, Life Style and Body – Self
in Self – Referred Woman to Weight Decrease Centers]. Knowl Res
Appl Psychol. 2007;0(32):121-44.
Holcomb WL, Jr., Stone LS, Lustman PJ, Gavard JA, Mostello DJ.
Screening for depression in pregnancy: characteristics of the Beck
Depression Inventory. Obstet Gynecol. 1996;88(6):1021-5. PMID:
Ho RC, Niti M, Kua EH, Ng TP. Body mass index, waist circumference,
waist-hip ratio and depressive symptoms in Chinese elderly: a
population-based study. Int J Geriatr Psychiatry. 2008;23(4):401-8.
DOI: 10.1002/gps.1893 PMID: 17879255
Kim KW, Kim SH, Shin JH, Choi BY, Nam JH, Park SC. Psychosocial,
physical, and autonomic correlates of depression in korean adults: results
from a county-based depression screening study. Psychiatry Investig.
;11(4):402-11. DOI: 10.4306/pi.2014.11.4.402 PMID:
Bogaerts AF, Devlieger R, Nuyts E, Witters I, Gyselaers W, Guelinckx
I, et al. Anxiety and depressed mood in obese pregnant women: a
prospective controlled cohort study. Obes Facts. 2013;6(2):152-64.
DOI: 10.1159/000346315 PMID: 23595249
Carter AS, Baker CW, Brownell KD. Body mass index, eating attitudes,
and symptoms of depression and anxiety in pregnancy and the
postpartum period. Psychosom Med. 2000;62(2):264-70. PMID:
Mannan M, Mamun A, Doi S, Clavarino A. Is there a bi-directional
relationship between depression and obesity among adult men and
women? Systematic review and bias-adjusted meta analysis. Asian J
Psychiatr. 2016;21:51-66. DOI: 10.1016/j.ajp.2015.12.008 PMID:
Feizi I, Baghi AN, Rahimi A, Nemati S. [The relationship between
BMI and depression among female students of medical sciences of
Ardebil]. J Ardabil Univ Med Sci. 2012;12(2):213-20.
Rafati F, Pilevarzadeh M, Mohammadisoleimani M, Salari S, Pormehr
A. [Body mass index associated with depression and mental health
nursing students in Jiroft]. J Endocrinol Metab. 2012;14(2):135-41.
Maddah M. [A review of the risk factors associated with obesity in
adults in Iran]. J Nutr Food Tech. 2012;7(1):119-27.
Crisp AH, McGuiness B. Jolly fat: relation between obesity and
psychoneurosis in general population. Br Med J. 1976;1(6000):7-9.