Elevated risk of adverse obstetric outcomes in pregnant women with depression

Abstract

Objective In this study, we evaluated the association between patient depression ratings at an initial obstetrics visit and adverse birth outcomes in African-American women. Study Design We conducted a retrospective cohort study of 261 pregnant, African American women who were screened with the Edinburgh Postnatal Depression Scale (EPDS) at their initial prenatal visit. Medical records were reviewed to assess pregnancy and neonatal outcomes, specifically pre-eclampsia, preterm birth, intrauterine growth retardation and low birth weight. Results Using multivariable logistic regression models, an EPDS score ≥ 10 was associated with increased risk for preeclampsia, preterm birth and low birth weight. An EPDS score ≥ 10 was associated with increased risk for intrauterine growth retardation but after controlling for behavioral risk factors this association was no longer significant. Conclusion A positive, patient-rated depression screening at the initial obstetrics visit depression is associated with increased risk for multiple adverse birth outcomes. Given the retrospective study design and small sample size, this finding should be confirmed in a prospective cohort study.

Transtornos mentais na gravidez e condições do recém-nascido: estudo longitudinal com gestantes assistidas na atenção básica

“…The presence of symptoms suggesting a diagnosis of probable depressive disorder was verified in 14.4% of the pregnant women evaluated; although this finding is lower than that of other countries, ranging from 22.0% to 34.9%, 17,19 our results are similar to the national studies performed with low socioeconomic pregnant women in the second and third trimesters of pregnancy 6,24 . The association between depression and obstetric outcomes is still poorly understood.…”

“…The association between depression and obstetric outcomes is still poorly understood. However, some studies have pointed to this disorder as a possible risk factor for low birth weight and prematurity 6,17,25 . In this study, no association was found between probable diagnosis of depressive disorder and LBW and prematurity.…”

“…The high frequency of MD during pregnancy is supported by the literature in national studies with populations of low socioeconomic status 2,5 and attended by PHC 14 . In international research, the prevalence of psychiatric symptoms, particularly anxiety and depression, varies from 11.8% to 34.9% [15][16][17][18][19] , depending not only on the socioeconomic aspects of the period of time investigated, but also on the tool used in the detection.…”

Intimate Partner Violence During Pregnancy and Adverse Neonatal Outcomes in Low-Income Women

“…Research suggests that maternal depression during pregnancy may be in an important risk factor for LBW and SGA; thus, maternal depressive symptomatology was included as a covariate. 33,34 Data analysis Preliminary analyses examined sociodemographic variables and key study variables to assess distribution of data, and to identify potential outliers and collinearity among variables. T-tests and chi-square analyses were used for continuous and categorical variables respectively.…”

Computer-Assisted Cognitive Behavioral Therapy for Pregnant Women with Major Depressive Disorder

“…The impact to the mother can be devastating as up to 3% of all pregnant women and 30% of depressed pregnant women report suicidal ideation. 4,5 The infant is also at risk as in untreated women, antenatal depressive symptoms have been linked to serious adverse birth outcomes 6 such as preterm birth, 7,8 lower birth weight, 9,10 pre-eclampsia, 11 and abnormal infant neuroendocrine development, 12 which all have significant long-term health and economic impacts. Beyond the immediate postpartum period, AD continues to have a negative health impact, as it has been associated with impairment in maternalfetal attachment and abnormal child development.…”