Gestational Weight Gain and Postpartum Depressive Symptoms in High-Income Women with Low and Late Fertility

Objective: This study aimed to investigate the relationship between GWG and postpartum depressive symptoms among high income women with ‘low and late fertility’, combined into a single category. Methods: We examined the impact of low and late fertility on GWG, based on pre-pregnancy body mass index (BMI) categories, and postpartum depressive symptoms, tested by the Edinburgh Postnatal Depression Scale (EPDS), in a cohort of 2,561 low-risk puerperae, prior to discharge from the maternity ward of Abano Polyclinic, Abano Terme (Italy). Postpartum depressive symptoms were evaluated separately using EPDS cut-off thresholds of > 9 and > 12, as well as the Anhedonia, Anxiety, and Depression subscales. Results: The women had a median age of 33.0 years (IQR: 30.0–37.0) and a parity of 1.00 (IQR: 1.00–2.00). A higher prevalence of pre-pregnancy underweight status (8.71 %) was observed compared to obesity (5.19 %). Additionally, 25.15 % of the participants had EPDS total scores > 9, and 10.89 % had scores > 12. Analysis revealed a significant overall association between pre-pregnancy BMI and GWG category (p < 0.001), with 47.30 % classified as having adequate GWG, 24.25 % as inadequate, and 28.43 % as excessive. Finally, GWG was not associated with an increased risk of elevated EPDS total scores (>9 or > 12) or with higher scores on the Anhedonia, Depression, or Anxiety subscales. Conclusion: In high-income women experiencing a late first pregnancy, the lack of association between abnormal GWG and postpartum psycho-emotional distress may be influenced by a higher prevalence of pre-pregnancy underweight status over obesity.