Depression during pregnancy in women with a medical disorder: risk factors and perinatal outcomes

Abstract

BACKGROUND:Approximately one‐fifth of women present depression during pregnancy and puerperium, and almost 13% of pregnant women experience a major depressive disorder.OBJECTIVE:The aim of this study was to identify risk factors for depression among pregnant women with a medical disorder and to evaluate the influence of depression on perinatal outcomes.METHODS:Three hundred and twenty‐six pregnant women with a medical disorder were interviewed. A semistructured interview was conducted for each participant using a questionnaire that had been developed previously. Major depression was diagnosed using the Portuguese version of the Primary Care Evaluation of Mental Disorders (PRIME‐MD). The medical records of the participants were thoroughly reviewed to evaluate the perinatal results.RESULTS:Major depressive disorder was diagnosed in 29 cases (9.0%). The prevalence of major depression was as follows: 7.1% for preeclampsia or chronic hypertension, 12.1% for cardiac disorder, 7.1% for diabetes mellitus, 6.3% for maternal anemia, 8.3% for collagenosis and 12.5% for a high risk of premature delivery. An univariate analysis showed a significant positive correlation between an average household income below minimum wage and a PRIME‐MD diagnosis of major depression. A multiple regression analysis identified unplanned pregnancy as an independent predictor of major depression (86.2% in the group with a diagnosis of major depression by PRIME‐MD vs. 68.4% in the group without major depression). A comparison between women who presented major depression and those who did not revealed no significant differences in the perinatal results (i.e., preterm delivery, birth weight and low Apgar scores).CONCLUSION:In the present study, unplanned pregnancy in women with a medical disorder was identified as a risk factor for major depression during gestation. Major depression during pregnancy in women with a medical disorder should be routinely investigated using specific methods.

Depressão entre puérperas: prevalência e fatores associados

“…Estudos sobre o tema identificaram que mulheres que apresentaram alguma complicação clínica durante a gravidez tiveram maior probabilidade de desenvolver depressão, o que pode ser explicado pela maior fragilidade em que a mulher se encontra ao enfrentar problemas de saúde durante a gestação 20,26 . Vale ressaltar que o efeito dos fatores de suporte profissional e a tendência linear se mantiveram ainda após o ajuste com as variáveis que mediam a morbidade das gestantes.…”

Depression, stress and guilt are linked to the risk of suicide associated to ectopic pregnancy

“…29 This study found a high rate (16%) of ideations that it would be better to die or somehow hurt oneself, which is indicative of a specific risk for suicide. A study conducted using the PRIME-MD to interview pregnant women with complicating conditions at the same health center as the one in this study found that 5% of the study population was at risk for suicide.…”

Psychiatric Disorders during Pregnancy and Postpartum

“…It has also been reported that multigravidas, women with current and past obstetric complications and history of previous abortions can also attribute to depression. Many studies support these facts [3,4,6,7,9].…”

“…Others can be age, marital status, parity, unwanted pregnancy, lack of social support, etc. [3][4][5][6][7][8][9][10]. Obese woman are more likely to experience elevated antenatal and postpartum depression [11].…”