The association between ante- and postnatal depressive symptoms and obesity in both mother and child: a systematic review of the literature.

Aim: The aim of this paper was to review the literature reporting on the relationship between ante- and postnatal maternal depressive symptoms and both maternal and childhood obesity.

Method: Articles were sourced from Medline, PsychInfo, Health Source: Nursing/Academic Edition, Academic Search Premiere, and CINAHL. The search was limited to English papers published between January 2000 and June 2011 with key search terms including a combination of maternal, ante- and postnatal depression, obesity, and child. After screening, this resulted in 14 articles, 9 that addressed maternal depressive symptoms and maternal obesity and 5 that focused on maternal depressive symptoms and childhood obesity. GRADE guidelines were used to assess the quality of evidence on two outcomes: Maternal overweight/obesity (body mass index [BMI]) and childhood overweight/obesity (BMI).

Results: Nine studies examined the association between postnatal depressive symptoms and maternal obesity; three were cross-sectional and six were longitudinal. None of the cross-sectional studies that examined the association between postnatal depressive symptoms and maternal obesity (BMI) reported a significant positive association. In contrast, of the six studies that used a longitudinal design, three found an association between depressive symptoms and maternal BMI. Five studies were found examining ante- and postnatal depressive symptoms and childhood obesity, four longitudinal and one cross-sectional. Three found a positive association-the cross-sectional study and two longitudinal studies. The quality of the evidence for the two outcomes-maternal and childhood obesity-was low.

Conclusion: Research addressing perinatal maternal depressive symptoms and maternal obesity, as well as research addressing perinatal maternal depressive symptoms and childhood obesity, is limited, is of low quality as a body of evidence, and thus far findings have been inconclusive. Further longitudinal and prospective research, incorporating objective measures of BMI and validated measures of depression, is warranted.