Antenatal Depressive Symptoms and Preterm Birth: A Prospective Study of a Swedish National Sample

Fransson, Emma; Örtenstrand, Annica; Hjelmstedt, Anna

doi:10.1111/j.1523-536x.2010.00441.x

Cited by 62 publications

(51 citation statements)

References 40 publications

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“…This cut-off score has been used previously in non-English-speaking pregnant women, including immigrants, 30 and was recently found to be associated with increased risk for preterm birth in a nonimmigrant sample. 31 SLEs were assessed with the CRISYS-R, a 63-item instrument that examines the occurrence of SLEs in the previous 6 months. The CRISYS-R was designed for use in a low-income, urban population and therefore captures many SLEs pertinent to the immigrant experience.…”

Section: Demographics and Psychosocial Assessmentmentioning

confidence: 99%

Antenatal Depression in a Multi-Ethnic, Community Sample of Canadian Immigrants: Psychosocial Correlates and Hypothalamic-Pituitary-Adrenal Axis Function

et al. 2013

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Objectives: Immigrant women living in Canada present with higher rates of prenatal depressive symptomatology than Canadian-born women; however, the associated psychosocial correlates remain understudied. Antenatal depression and stress negatively affect maternal health and infant development, in part through changes in maternal hypothalamic-pituitary-adrenal (HPA) axis activity. We aimed to examine the factors associated with prenatal depressive symptoms, including altered HPA axis function, in an ethnically diverse community sample of Canadian immigrant women.Methods: Seventy-eight pregnant immigrant women were recruited from the community at 19 weeks' gestation and provided information on health, mood, stressful life events (SLEs), and social support. Fifty-seven of these women also provided saliva samples for measurement of the cortisol awakening response and nighttime cortisol levels.Results: Seventeen per cent of the sample had a high level of prenatal depressive symptoms, and these women reported more perceived stress, more somatic symptoms, lower social support, and were less often working or attending school during pregnancy. Controlling for wake time, parity, and region of origin, high levels of prenatal depressive symptoms were associated with elevated nighttime cortisol levels, whereas SLEs were not associated with any measures of HPA axis activity. Conclusions:High levels of prenatal depressive symptoms are common in immigrant women living in Canada, and are associated with identifiable factors. Preliminary evidence suggests a similar pattern of HPA axis activity characterizing depressive symptomatology in this subpopulation as previously seen in clinically depressed patients. W W W Dépression prénatale dans un échantillon communautaire multiethnique d'immigrantes canadiennes : corrélats psychosociaux et fonction de l'axe hypothalamo-hypophyso-surrénalienObjectifs : Les femmes immigrantes habitant le Canada présentent des taux plus élevés de symptomatologie dépressive prénatale que les femmes canadiennes de naissance; cependant, les corrélats psychosociaux associés demeurent sous-étudiés. La dépression prénatale et le stress influent négativement sur la santé maternelle et le développement du bébé, en partie à cause de changements d'activité de l'axe hypothalamo-hypophysosurrénalien (HHS) maternel. Nous cherchions à examiner les facteurs associés aux symptômes dépressifs prénataux, notamment la fonction altérée de l'axe HHS, dans un échantillon communautaire ethniquement diversifié de femmes immigrantes canadiennes.

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Section: Demographics and Psychosocial Assessmentmentioning

confidence: 99%

Antenatal Depression in a Multi-Ethnic, Community Sample of Canadian Immigrants: Psychosocial Correlates and Hypothalamic-Pituitary-Adrenal Axis Function

et al. 2013

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“…In particular, antenatal anxiety and depression are associated with preterm birth (Orr et al, 2007;Fransson et al, 2011) and have adverse implications for fetal neurodevelopment (Kinsella and Monk, 2009) and child outcomes (Conde et al, 2010;Alder et al, 2007). Beyond that, studies have shown that antenatal anxiety and depression are risk factors for postnatal depression (Milgrom et al, 2008); Yonkers et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Fadzil

Balakrishnan²,

Razali

et al. 2013

Asia-Pacific Psychiatry

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Introduction: Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics. Methods: A cross-sectional survey design was used. A total of 175 antenatal mothers participated. Their socio-demographic and obstetric histories were recorded. The Hospital Anxiety and Depression Scale (HADS) and Mini International Neuropsychiatric Interview (M.I.N.I.) were used. Results: The prevalence of anxiety and depression disorders among antenatal mothers using diagnostic clinical interview were 9.1% and 8.6%, respectively. Factors associated with antenatal anxiety were marital status (being unmarried), positive history of mental illness, gestational age (<20 weeks), unplanned pregnancy and depressive comorbidity. However, only gestational age of less than 20 weeks and depressive disorder remained significant factors in the multivariate analysis. Discussion: The prevalence rate of antenatal depression detected by HADS screening was comparable to the rate from diagnostic interview, but there was a slight overestimation for antenatal anxiety. Nonetheless, HADS as a screening tool offers a practical solution for detecting these two conditions in a busy antenatal clinic or a large epidemiological survey. In view of the deleterious effects of antenatal anxiety and depression on mothers and children, these two conditions should be screened and managed appropriately.

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“…Women with antenatal depression are at risk for interpersonal isolation and suicide, are less likely to receive adequate nutrition and obstetrical care, and are more likely to engage in smoking and substance abuse (Marcus and Heringhausen, 2009;Zuckerman et al, 1989). In infants, active depressive symptoms during pregnancy are associated with shorter length of gestation, restricted fetal growth, and lower birth weight (Davalos et al, 2012;Fransson et al, 2011;Grote et al, 2010). Gestational depression is one of the strongest predictors of postpartum depression (Dietz et al, 2007;Gaynes et al, 2005;Milgrom et al, 2008), which is associated with decreased maternal sensitivity and attachment (Campbell et al, 2004;Lindahl et al, 2005;McLearn et al, 2006;Paulson et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Rate of Chiari I Malformation in Children of Mothers with Depression with and without Prenatal SSRI Exposure

Knickmeyer

Meltzer‐Brody

Woolson

et al. 2014

Neuropsychopharmacol

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Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed to pregnant women. Therefore, research on in utero exposure to SSRIs can be helpful in informing patients and clinicians. The aim of this retrospective two-cohort study was to determine whether there is a statistically significant increase in Chiari I malformations (CIM) in children exposed to SSRIs during pregnancy. A total of 33 children whose mothers received a diagnosis of depression and took SSRIs during pregnancy (SSRI-exposed cohort) were matched to 66 children with no history of maternal depression and no SSRI exposure. In addition, 30 children whose mothers received a diagnosis of depression, but did not receive antidepressants during pregnancy (history of maternal depression cohort), were matched to 60 children with no history of maternal depression and no SSRI exposure. Main outcome was presence/absence of CIM on MRI scans at 1 and/or 2 years of age. Scans were reviewed by two independent neuroradiologists who were blind to exposure status. The SSRI-exposed children were significantly more likely to be classified as CIM than comparison children with no history of maternal depression and no SSRI exposure (18% vs 2%, p ¼ 0.003, OR estimate 10.32, 95% Wald confidence limits 2.04-102.46). Duration of SSRI exposure, SSRI exposure at conception, and family history of depression increased the risk. The history of maternal depression cohort did not differ from comparison children with no history of maternal depression and no SSRI exposure in occurrence of CIM (7% vs 5%, p ¼ 0.75, OR estimate 1.44, 95% Wald confidence limits 0.23-7.85). Replication is needed, as is additional research to clarify whether SSRIs directly impact risk for CIM or whether this relationship is mediated by severity of depressive symptoms during pregnancy. We would discourage clinicians from altering their prescribing practices until such research is available.

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Antenatal Depressive Symptoms and Preterm Birth: A Prospective Study of a Swedish National Sample

Abstract: Pregnant women reporting antenatal depressive symptoms are at elevated risk of preterm birth.

Cited by 62 publications

References 40 publications

Antenatal Depression in a Multi-Ethnic, Community Sample of Canadian Immigrants: Psychosocial Correlates and Hypothalamic-Pituitary-Adrenal Axis Function

Antenatal Depression in a Multi-Ethnic, Community Sample of Canadian Immigrants: Psychosocial Correlates and Hypothalamic-Pituitary-Adrenal Axis Function

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Rate of Chiari I Malformation in Children of Mothers with Depression with and without Prenatal SSRI Exposure

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