Antenatal depressive symptoms increase the likelihood of preterm birth

• Published in: American journal of obstetrics and gynecology Vol. 207; no. 4; pp. 329.e1 - 329.e4
• Main Authors: Straub, Heather, MD, Adams, Marci, MPH, Kim, J. Jo, PhD, Silver, Richard K., MD
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01-10-2012; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Biological and medical sciences; Cohort Studies; Depression; Depression - complications; Depression - diagnosis; Diseases of mother, fetus and pregnancy; Female; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infant, Premature; Maternal Age; Medical sciences; Miscellaneous; Mood disorders; Obstetrics and Gynecology; perinatal depression; Pregnancy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Premature Birth - etiology; Premature Birth - psychology; preterm birth; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Surveys and Questionnaires; preterm birth; perinatal depression; Mood disorder; Prenatal; Pregnancy disorders; Prematurity; Gynecology; Premature delivery; Depression; Obstetrics
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2012.06.033

Objective We evaluated the relationship between antenatal depressive symptoms and preterm birth. Study Design Patients completed the Edinburgh Postnatal Depression Scale between 24-28 weeks of gestation. A score ≥12 (or thoughts of self-harm) indicated an at-risk woman. Symptomatic women were compared to risk-negative patients for relevant demography, historical variables, and pregnancy outcome. Results After screening 14,175 women we found a screen positive rate of 9.1% (n = 1298). At-risk women had a significant increase in preterm birth at <37, <34, <32, and <28 weeks of gestation. Multivariable analysis adjusting for maternal age, race/ethnicity, prior preterm delivery, and insurance status revealed a persistent association between antenatal depressive symptoms and preterm birth (adjusted odds ratio, 1.3; 95% confidence interval, 1.09–1.35), which was also observed after multiple gestations were excluded from the analysis (odds ratio, 1.7; 95% confidence interval, 1.38–1.99). Conclusion In this large cohort of prenatally screened women, those with depressive symptoms had an increased likelihood of preterm birth.