A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study
Abstract Background Studies have found an association between obesity and an increased risk for peripartum depression, which has also been linked to decreased placental lactogen levels. In addition, women with obesity treated for gestational diabetes with insulin were found to have increased levels...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-021-01261-0 |
| _version_ | 1819160266838900736 |
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| author | Jessica S. Jarmasz Alexandrea Anderson Margaret E. Bock Yan Jin Peter A. Cattini Chelsea Ruth |
| author_facet | Jessica S. Jarmasz Alexandrea Anderson Margaret E. Bock Yan Jin Peter A. Cattini Chelsea Ruth |
| author_sort | Jessica S. Jarmasz |
| collection | DOAJ |
| description | Abstract Background Studies have found an association between obesity and an increased risk for peripartum depression, which has also been linked to decreased placental lactogen levels. In addition, women with obesity treated for gestational diabetes with insulin were found to have increased levels of placental lactogen. Treatment options exist for perinatal and postpartum depression however they pose a risk to the developing offspring. Thus, prevention as well as markers for early identification of peripartum depression are needed. Therefore, our study objective is to identify the association between insulin treatment in pregnancy and the risk of postpartum psychological distress (abbreviated here as PPD) among cohorts of women with and without obesity. Methods Administrative health data (2002/03–2018/19) were used to identify a cohort of women (age 15+ years) who gave birth (N = 250,746) and had no pre-existing mood/anxiety disorders or diabetes (N = 222,863 excluded). Women were then divided into two groups: lean (N = 17,975) and with obesity (N = 9908), which was identified by a recorded maternal weight of > 38 to < 65.6 kg and ≥ 85 to < 186 kg (respectively). The risk of PPD within one year after delivery with and without insulin treatment was assessed by Poisson regression analysis. Models were adjusted for maternal age group (at pregnancy start date) and area-level income (at delivery). Results The unadjusted risk of PPD was higher in the obesity group (8.56%; 95% CI 8.00–9.15) than in the lean group (6.93%; 95% CI 6.56–7.33). When no insulin treatment was given during pregnancy, mothers with obesity had a significantly higher risk of PPD than the lean group (aRR 1.27; 95% CI 1.17–1.39; p < 0.0001). However, when women with obesity and insulin treatment were compared to the lean group with no insulin treatment, no significant difference in the risk of PPD was observed between the groups (aRR 1.30; 95% CI 0.83–2.02; p = 0.248). Conclusion This is the first study to demonstrate a positive association between insulin treatment in pregnancy among women with obesity and reduced PPD rates, suggesting insulin as a possible preventative measure. However, the biological mechanism behind the observed positive effect of insulin on PPD rates remains to be investigated. |
| first_indexed | 2024-12-22T16:53:43Z |
| format | Article |
| id | doaj.art-be207ed1940f4465990d6309a5631a93 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-12-22T16:53:43Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-be207ed1940f4465990d6309a5631a932022-12-21T18:19:32ZengBMCBMC Women's Health1472-68742021-03-0121111110.1186/s12905-021-01261-0A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health studyJessica S. Jarmasz0Alexandrea Anderson1Margaret E. Bock2Yan Jin3Peter A. Cattini4Chelsea Ruth5Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaDepartment of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaDepartment of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaDepartment of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaDepartment of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaDepartment of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaAbstract Background Studies have found an association between obesity and an increased risk for peripartum depression, which has also been linked to decreased placental lactogen levels. In addition, women with obesity treated for gestational diabetes with insulin were found to have increased levels of placental lactogen. Treatment options exist for perinatal and postpartum depression however they pose a risk to the developing offspring. Thus, prevention as well as markers for early identification of peripartum depression are needed. Therefore, our study objective is to identify the association between insulin treatment in pregnancy and the risk of postpartum psychological distress (abbreviated here as PPD) among cohorts of women with and without obesity. Methods Administrative health data (2002/03–2018/19) were used to identify a cohort of women (age 15+ years) who gave birth (N = 250,746) and had no pre-existing mood/anxiety disorders or diabetes (N = 222,863 excluded). Women were then divided into two groups: lean (N = 17,975) and with obesity (N = 9908), which was identified by a recorded maternal weight of > 38 to < 65.6 kg and ≥ 85 to < 186 kg (respectively). The risk of PPD within one year after delivery with and without insulin treatment was assessed by Poisson regression analysis. Models were adjusted for maternal age group (at pregnancy start date) and area-level income (at delivery). Results The unadjusted risk of PPD was higher in the obesity group (8.56%; 95% CI 8.00–9.15) than in the lean group (6.93%; 95% CI 6.56–7.33). When no insulin treatment was given during pregnancy, mothers with obesity had a significantly higher risk of PPD than the lean group (aRR 1.27; 95% CI 1.17–1.39; p < 0.0001). However, when women with obesity and insulin treatment were compared to the lean group with no insulin treatment, no significant difference in the risk of PPD was observed between the groups (aRR 1.30; 95% CI 0.83–2.02; p = 0.248). Conclusion This is the first study to demonstrate a positive association between insulin treatment in pregnancy among women with obesity and reduced PPD rates, suggesting insulin as a possible preventative measure. However, the biological mechanism behind the observed positive effect of insulin on PPD rates remains to be investigated.https://doi.org/10.1186/s12905-021-01261-0Maternal obesityPostpartum psychological distressInsulinGestational diabetesMood and anxiety disorderPregnancy |
| spellingShingle | Jessica S. Jarmasz Alexandrea Anderson Margaret E. Bock Yan Jin Peter A. Cattini Chelsea Ruth A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study BMC Women's Health Maternal obesity Postpartum psychological distress Insulin Gestational diabetes Mood and anxiety disorder Pregnancy |
| title | A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study |
| title_full | A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study |
| title_fullStr | A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study |
| title_full_unstemmed | A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study |
| title_short | A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study |
| title_sort | potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity an administrative population health study |
| topic | Maternal obesity Postpartum psychological distress Insulin Gestational diabetes Mood and anxiety disorder Pregnancy |
| url | https://doi.org/10.1186/s12905-021-01261-0 |
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