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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

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Volume 46, Issue 1


The association between pre-pregnancy obesity and screening results of depression for all trimesters of pregnancy, postpartum and 1 year after birth: a cohort study

Hanieh Salehi-Pourmehr
  • Neuroscience Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Sakineh Mohammad-Alizadeh
  • Department of Midwifery, Faculty of Nursing and Midwifery, Research Center of Social Determinants of Health, Tabriz University of Medical Sciences, Tabriz, Iran
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nayyer Jafarilar-Agdam / Somayyeh Rafiee / Azizeh Farshbaf-Khalili
  • Corresponding author
  • Physical Medicine and Rehabilitation Research Centre, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran, Tel.: +984134796770, Fax: +984134796969, Mobile: +989144023216, E-mail:
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Published Online: 2017-02-17 | DOI: https://doi.org/10.1515/jpm-2016-0277



To determine the relationship between pre-pregnancy obesity and screening results of gestational and post-delivery depression in women referred to the health centers of Tabriz, Iran.


In this cohort study, 62 and 245 pregnant women with class 2–3 obesity [body mass index (BMI)≥35 kg/m2] and normal-weight (BMI 18.5–24.9 kg/m2) were enrolled, respectively, in the first trimester of pregnancy from December 2012 to January 2016. For matching of groups, nulliparous and multiparous mothers aged 18–35 years were selected with the ratio of 1:4 in obese and normal BMI groups from the same recruitment center and to controlling the confounder factors, inclusion criteria were considered. The Edinburgh Postnatal Depression Scale (EPDS) was completed in five time points, the first, second, third trimester of pregnancy, 6–8 weeks and 12 months after delivery. Independent t-test, Mann-Whitney, chi-square, Fisher’s exact tests and multivariate logistic and linear regression adjusted for confounders were used. P<0.05 was considered as statistically significant.


Based on the EPDS, 12.7% of normal weight women in first, 13.5% in second, 10.2% in third trimester of pregnancy, 7.8% in 6–8 weeks of postpartum and 10.6% in 1 year after delivery screened positive for depression. This proportion was greater in class 2–3 obese women (32.3%, 33.3%, 28.8% in trimesters of pregnancy and 35.4%, 19.4% in postpartum period, respectively) (P<0.05). The results of multivariate logistic regression adjusted for confounding factors showed that the risk of depression in the first trimester of pregnancy for class 2–3 obesity was 3.25-fold greater than normal weight group [adjusted odds ratio (aOR) 3.25, 95% confidence interval (CI) 1.68–6.28]. This risk was 3.29-fold in the second (aOR 3.29, 95% CI 1.67–6.47), 4-folds in the third trimester (aOR 4.003, 95% CI 1.84–8.70 for third), 7.5-fold in the 6–8 weeks of postpartum (aOR 7.46, 95% CI 3.30–16.89) and 1.83-fold (aOR 7.46, 95% CI 3.30–16.89) for 1 year after birth.


Pre-pregnancy obesity was associated with probability of gestational and post-delivery depression. Therefore, training and planning to conduct required interventions to resolve obesity seem be helpful in this regard.

Keywords: Body mass index (BMI); depression; obesity; postpartum; pregnancy


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About the article

Received: 2016-08-17

Accepted: 2017-01-12

Published Online: 2017-02-17

Published in Print: 2018-01-26

Funding Source: Tabriz University of Medical Sciences

Award identifier / Grant number: 91163

Source of funding: This study was supported by Tabriz University of Medical Sciences (Grant number: 91163).

Author’s statement

Conflict of interest: Authors state no conflict of interest.

Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

Citation Information: Journal of Perinatal Medicine, Volume 46, Issue 1, Pages 87–95, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2016-0277.

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