Prevalence of Depression in Pregnant Women with Bariatric Surgery History and Associated Factors

Rocha, Andréa Christina Nowak da; Cunha, Ana Cristina Barros da; Silva, Jaqueline Ferreira da

doi:10.1055/s-0042-1742682

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Revista Brasileira de Ginecologia e Obstetrícia

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Sumário

Original Article • Rev. Bras. Ginecol. Obstet. 44 (02) • Feb 2022 • https://doi.org/10.1055/s-0042-1742682 copy

Prevalence of Depression in Pregnant Women with Bariatric Surgery History and Associated Factors

Prevalência de depressão em gestantes com histórico de cirurgia bariátrica e fatores associados

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze the prevalence and factors associated with depressive symptoms among Brazilian pregnant women with history of bariatric surgery (BS).

Methods

This is a cohort study with 247 women who got pregnant after BS. Based on data collection via Google Form, the recruitment of participants occurred in Facebook groups for 13 months. All of them answered a form with Informed Consent, a general data protocol and the Brazilian version of the Depression, Anxiety and Stress Scale-21. Descriptive and inferential analysis were performed, and a binary logistic regression model was tested to predict the factors associated with depressive symptoms.

Results

The prevalence of depressive symptoms was 32.8%, noted as being higher in the first (40.6%) and third (34.3%) gestational trimesters. Significative associations were found between depression and marital status (p=0.000), planned pregnancy (p=0.001), desired pregnancy (p=0.004) and psychiatric history (p=0.000). Women who were not married (odds ratio, OR=3,38; p=0.002) and had a psychiatric history (OR=2.70; p=0.102) had higher chances of showing depression symptoms; while planned and desired pregnancy showed as protective factors to the symptoms of depression.

Conclusion

These findings highlight the importance of psychological assistance for pregnant women with history of BS, to prevent development of mental disorders and their outcomes for maternal-child health.

Keywords:
bariatric surgery; pregnancy; mental health; depression; perinatal care

Variables	Category	n	%
Marital status	Single	33	13.4
	Married	209	84.6
	Divorced	5	2.0
Total		247	100
Race/Ethnics	Yellow	3	1.2
	White	160	64.8
	Mixed race (parda)	61	24.7
	Black	14	5.7
	No answer	9	3.6
Total		247	100
Age group	20 to 24 years	18	7.3
	30 to 34 years	95	38.5
	35 to 39 years	54	21.9
	40 to 44 years	10	4
Total		247	100
Education	Incomplete elementary school	1	0.4
	Complete elementary school	2	0.8
	Incomplete middle school	8	3.2
	Complete college	116	47.0
Total		247	100
Labor Activity	Yes	184	74.5
Labor Activity	No	63	25.5
Total		247	100
Family income	No income	7	2.8
	To 2 minimum wage	32	13.0
	From 2 to 4 minimum wage	108	43.7
	From 4 to 10 minimum wage	82	33.2
	From 10 to 20 minimum wage	13	5.3
	More than 20 minimum wage	5	2.0
Total		247	100
Brazilian region	North	2	0.8
	Northeast	33	13.4
	Center-West	16	6.5
	Southeast	132	53.4
	South	64	25.9
Total		247	100
Prenatal assistance	Public institution	50	20.2
	Private institution	188	76.1
	No monitoring	9	3.6
Total		247	100

Indicators of clinical health	Frequency	%
Gestational age
1 to 13 weeks (1^st Trimester)	64	25.9
14 to 26 weeks (2^nd Trimester)	84	34.0
27 to 40 weeks (3^rd Trimester)	99	40.1
Total	247	100
Time of BS
Less than 6 months	7	2.8
6 to 11 months and 30 days	28	11.3
12 to 17 months and 30 days	55	22.3
18 months to 23 months and 30 days	35	14.2
More than 24 months	122	49.4
Total	247	100
Type of BS
Gastric bypass	216	87.4
Vertical gastrectomy	31	12.6
Total	247	100
Time of medical supervisor after BS
Less than 6 months	25	10.1
6 months to 1 years	52	21.1
1 year to 2 years	53	21.5
Still on supervisor	117	47.4
Total	247	100
Diseases before pregnancy
Clinical pathologies	132	53.4
History of psychiatric disorders	30	12.1
Both	33	13.4
None	52	21.1
Total	247	100
Compulsive behaviors
Bulimia nervosa	8	11.3
Anorexia nervosa	2	2.8
Binge eating disorder	13	18.3
Alcohol use disorder	2	2.8
Disorder related to substance abuse (sedatives, hypnotics, anxiolytics or drugs)	1	1.4
Other compulsions(sex, gambling, physical exercise, shopping etc.)	2	2.8
No	43	60.6
Total	71	100
Didn't answer	176	0

Variables	No depressive symptoms		With depressive symptomatology
	n	%	n	%	P-value
Marital status					0.000*
Unmarried	16	41	23	16
Married	150	72.1	58	150
Education					0.062
Completed and uncompleted elementary school	3	100	0	0
Completed and uncompleted high school	56	75.7	18	24.3
Completed and uncompleted college	107	66	55	34
Family income					0.096
No income	4	57.1	3	42.9
Up to 2 minimum wage	17	53.1	15	46.9
From 2 to 4 minimum wage	79	73.1	29	26.9
From 4 to 10 minimum wage	52	63.4	30	36.6
From 10 to 20 minimum wage	10	76.9	3	23.1
More than 20 minimum wage	4	80	1	20
Labor activity					0.177
Yes	150	71.1	58	28.9
No	16	41	23	59
Planned pregnancy					0.001**
Yes	96	77.4	28	96
No	70	56.9	53	70
Desired pregnancy					0.004*
Yes	151	70.6	63	29.4
No	15	45.5	18	54.5
Emotional support					0.605
Yes	66	65.3	35	34.7
No	100	68.5	46	31.5
Financial support					0.238
Yes	8	53.3	7	46.7
No	158	68.1	74	31.9
History of obesity					0.974
Obese since childhood	21	70	9	30
Obese as of adolescence	18	69.2	8	30.8
Obese as of adulthood	10	66.7	5	33.3
Gestational age					0.122
1^st Trimester	38	59.4	26	40.6
2^nd Trimester	63	75	21	25
3^rd Trimester	65	65.7	34	34.3
History of psychiatric disorders					0.000*
Yes	31	49.2	32	50.8
No	45	86.5	7	13.5
Compulsive behaviors					0.197
Eating disorder	11	52.4	10	47.6
Disorder related to use of some substance	2	66.7	1	33.3
Other compulsions	1	50	1	50
No	35	77.8	10	22.2

Variables	β	OR	95% CI	P-value
Marital status	1.219	3.38	1.586–7,221	0.002**
Planned pregnancy	-0.530	0.59	0.312–1,111	0.102
Wanted pregnancy	-0.592	0.55	0.234–1,305	0.438
History ofpsychiatry disorder	0.994	2.70	1.438–5,081	0.002**

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[1] Address for correspondence
Andréa Christina Nowak da Rocha, Psychologist, Master’s degree, Rua Aires Saldanha, 136/ 704, 22060- 030, Copacabana, Rio de Janeiro, RJ, Brazil (e-mail: andreanowak@hotmail.com).