Pre-pregnancy body mass index, depression, and excessive gestational weight gain in black and Hispanic pregnant women

Shieh, Carol

Sunday, 17 November 2013: 11:00 AM

Carol Shieh, RNC-OB, DNSc
School of Nursing, Indiana University, Indianapolis, IN
Lauren Tomey, BSN (s)
Indiana University School of Nursing, Indianapolis, IN

Learning Objective 1: Participants will be able to list two ways to measure body weight status in pregnant women

Learning Objective 2: Participants will be able to describe how race influences prenatal depression and gestational weight gain

Obesity and depression contribute to adverse pregnancy outcomes. One third of pregnant women are obese, 25% are depressed, and 50% gain excessive gestational weight. Ethnic minority women are particularly at risk for obesity, depression, and excessive gestational weight gain (EGWG). Researchers have proposed using pre-pregnancy body mass index (BMI) as a biometric marker for assessing prenatal depression and EGWG. The relationships of pre-pregnancy BMI, depression, and EGWG have yet to be investigated. This study examined the relationships of these three variables in black and Hispanic pregnant women.

Using a cross-sectional design, this study included 34 black and 53 Hispanic adult pregnant women recruited from two community health centers in the Midwest. Pre-pregnancy BMI was calculated from self-reported weight and height and grouped into under/normal weight (BMI < 25) and overweight/obese (BMI ≥ 25). Edinburgh Prenatal Depression Scale (10 questions, 4-point Likert format) measured depression; scores ≥ 10 were classified as possible depression. EGWG was defined as trimester-specific weight gain exceeding the Institute of Medicine’s recommendation. Student’s t and Chi-Square tests were used for analysis.

65% of women were overweight/obese, 25% were depressed, and 45% had EGWG. Frequencies of depression and EGWG were higher in the second and third trimesters (32% -52%) than in the first trimester (4% -18%). Pre-pregnancy BMI was not associated with depression or EGWG. Prenatal depression was not related to EGWG either. Black women were more likely than Hispanic women to be heavier (p = .0006), taller (p = .000), and have EGWG (58% vs 28%; p = .03).

This study did not find statistical significant relationships among BMI, depression, and EGWG. However, depression and EGWG occur throughout pregnancy and should be assessed in each trimester. Black women are more at risk than Hispanic women for EGWG. Culturally relevant nursing intervention targeting weight gain is needed.

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