Depressive Symptoms Prior to Pregnancy and Infant Low Birth Weight in South Africa

Abstract

Despite improvements in service delivery and patient management, low birth weight among infants has been a persistent challenge in South Africa. The study aimed to explore the relationship between depression before pregnancy and the low birth weight (LBW) of infants in post-apartheid South Africa. This study utilized data from Waves 1 and 2 of the South African National Income Dynamics Study, the main outcome being a dichotomous measure of child LBW (<2500 g) drawn from the Wave 2 child questionnaire. Depressive symptoms of non-pregnant women was the main predictor drawn from the Wave 1 adult questionnaire. Depressive symptoms were screened using the 10-item four-point Likert version of the Center for Epidemiologic Studies Depression Scale (CES-D) instrument. A total score of 10 or greater on the CES-D indicates a positive screen for depressive symptoms. An adjusted logistic regression model was used to examine the relationship between women’s depression before pregnancy and infant LBW. A sample size of 651 women in Wave 1 was linked to 672 newborns in Wave 2. The results of the adjusted logistic regression model indicated depressive symptoms (CES-D ≥ 10) prior to pregnancy were associated with infant LBW (adjusted OR 2.84, 95 % CI 1.08–7.46). Another significant covariate in the model was multiple childbirths. Our finding indicates that women’s depressive symptoms prior to pregnancy are associated with the low birth weight of newborns and suggests that this association may not be limited to depression present during the ante-natal phase.

Income inequality and depressive symptoms in South Africa: A longitudinal analysis of the National Income Dynamics Study

“…CES-D-10 scores were calculated following procedures used in previous studies (Alaba & Chola, 2013; Meffert, McCulloch, Neylan, Gandhi, & Lund, 2015; Tomita, Labys, & Burns, 2015a, 2015b) to create scores ranging from 0 to 30, indicating increasing symptomatology. Individuals missing five or more items in the scale were excluded.…”

“…Sensitivity analyses dichotomizing depressive symptoms using a cutoff score of 10, as has been used and validated in previous research (Andresen et al, 1994); Bjorgvinsson, Kertz, Bigda-Peyton, McCoy, & Aderka, 2013; Meffert et al, 2015; Tomita et al, 2015a, 2015b), were also run for comparison.…”

Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa

“…At each survey, a range of economic, health and wellbeing data were collected from all household members of 15 years of age or more. While a few studies from the first waves of NIDS used the CES-D-10 as a longitudinal measure of depression severity [18–20], most have used a cut-off of 10 to classify participants at high risk of depression, as suggested by Andresen [21–24]. …”

Screening for Antepartum Depression Through Community Health Outreach in Swaziland

“…Depression during pregnancy is known to impact infant health (8): maternal depression is associated with low infant birth weight (9), shorter duration of breastfeeding (10), diarrhoeal diseases and stunting (11), poor neurodevelopment (12), as well as reduced quality of interaction between mothers and infants (13). Maternal depression, including antenatal and postnatal depression, is also associated with significant impairment and disability, and suicide (14, 15)…”