Association between high pre-pregnancy body mass index and antenatal depression: A study among pregnant women of upper socio-economic strata in North-West Delhi, India

Background: Magnitude of antenatal depression (AD) remains underexplored especially in the Indian population despite the growing body of research regarding the benefits of healthy pregnancy. Further, National Family Health Survey (NFHS- 3 and NFHS-4) data indicate that there is an escalating rise in the proportion of overweight/obese women of reproductive age from 26.4% to 34.9% residing in Delhi. Synergistic impact of high pre-pregnancy weight and AD can adversely affect obstetric outcome. Hence, the present study aimed to assess and compare the prevalence of AD among normal weight, overweight and obese pregnant women. Methods: Present data is a part of an ongoing longitudinal study among pregnant women belonging to upper socio-economic strata residing in Delhi, India. A total of 186 subjects attending private antenatal clinics in North-West Delhi were enrolled at ≤16 week of gestation. The subjects were screened for AD using Edinburgh Postnatal Depression Scale, regularly at baseline (≤16th week), midterm (18th-20th week) and end-line (≥32nd week) of their pregnancies. Additional socio-demographic characteristics, anthropometric measurements and obstetric history were recorded and analysed using SPSS (Statistical Package for Social Sciences) version 25. Results: More than one-third of subjects screened positive for depression throughout pregnancy. Prevalence of AD was highest among obese subjects (50%,48.3%,51%) as compared to normal weight (36.7%,30.4%,37.5%) and overweight (27.6%,32%,29.2%) subjects during baseline, midterm and end-line respectively. Conclusion: Prevalence of AD was high irrespective of weight category. Obese women were likely to have more symptoms of depression compared to normal weight and overweight women throughout pregnancy. A holistic approach needs to be adopted by health care professionals including regular screening of AD and provide healthy lifestyle related advice to pregnant women