Long-Term Effects of Chronic Depressive Symptoms Among Low-Income Childrearing Mothers

Objectives: Longitudinal studies of maternal depression in the postpartum period have demonstrated that a chronic state of depressive symptoms is not rare. In spite of this, however, the characteristics of chronically depressed mothers have rarely been studied. This study examines the demographic and socioenvironmental characteristics across time of childrearing women with chronic depressive symptoms. Methods: A cohort of 476 childrearing lower-income mothers was interviewed from the first trimester of pregnancy through the tenth year postpartum. The Center for Epidemiologic Studies-Depression Scale (CES-D; Radloff, L. (1977) Appl Psychol Meas 1:385–401) was used to define depressive symptomatology. Four groups were defined based on the CES-D scores at 18 months, 3, 6 and 10 years: never-depressed (CES-D < 16), depressed only at one phase (CES-D ≥ 16), chronically mildly depressed (CES-D > 16 and ≤24 at three or more phases), and chronically severely depressed (CES-D ≥ 25 at three or more times). Demographic and socioenvironmental characteristics of the groups were evaluated across time. Results: Chronically depressed women compared to never-depressed women were less likely to be married, had less education, had lower family income, and were more likely to use substances. They reported more frequent arguments with close family members or friends, separation/divorce with partners, financial problems, less social support, and more financial strain. Conclusions: Women who continue to be depressed across the 10 postpartum years have less optimal outcomes compared to women who are not depressed and those who are only intermittently depressed. Pregnancy and delivery and subsequent pediatric visits are important times to identify women who are depressed.     

孕期妇女体力活动变化对抑郁影响的队列研究

目的 探究孕妇在孕早-中期体力活动变化对孕中期抑郁的影响。方法 依托中国孕产妇队列研究·协和项目（2017年7月25日至2018年11月26日）,将有效完成孕早、中期体力活动和抑郁情况调查的2 454名孕妇纳入研究。采用国际体力活动短问卷和爱丁堡产后抑郁量表,调查研究对象孕早期和孕中期的体力活动和抑郁情况。以孕早期是否患有抑郁作分组。采用非条件logistic回归分析孕早期不患抑郁组的孕早、中期体力活动变化对预防孕中期抑郁的作用,在孕早期抑郁组中分析孕早、中期体力活动变化对减缓孕中期抑郁的作用。结果 孕妇基线和孕中期抑郁的检出率分别为23.83%和20.57%。调整年龄、文化程度、职业、家庭年收入和孕前BMI等因素后,logistic回归结果显示,对于基线不抑郁的孕妇,孕期增加和保持充足的体力活动能够预防孕中期抑郁（OR=0.479,95% CI：0.335～0.684;OR=0.566,95% CI：0.394～0.815）,但对于基线抑郁的孕妇,体力活动与减缓孕中期抑郁的相关性差异无统计学意义（P>0.05）。结论 孕期妇女增加和保持充足的体力活动对于抑郁有预防的作用,但对于孕早期已患抑郁的妇女来说,缓解效果不明显。应在鼓励孕妇加强体力活动的同时,开展抑郁筛查,以减少孕期抑郁的发生。     

Depression and Anxiety in Women During Pregnancy in Slovenia

Objective

The aim of the study was to evaluate the prevalence of elevated depression and anxiety among pregnant women and to examine its correlation with medical complications and socio-demographic characteristics.

Methods

The study is based on a cross-sectional design of a sample of 348 women in three trimesters of pregnancy who received routine obstetrical care at the University Medical Centre Ljubljana, Department of Obstetrics and Gynaecology. The responding women filled out a questionnaire on socio-demographic variables, the Centre for Epidemiologic Studies Depression Scale CES-D and the State Trait Anxiety Inventory STAI.

Results

21.7% of pregnant women were identified as suffering from elevated depression symptomatology, 15.7% reported high state anxiety and 12.5% had high trait anxiety. No significant differences in depression and anxiety across pregnancy trimesters were found. The women who have suffered from health complications during previous pregnancies showed higher state anxiety; those experiencing complications during their current pregnancy reported more intense symptoms of depression and of state and trait anxiety than women free of complications. Less educated, lower income and mothers of many children in the third pregnancy trimester reported more intensive symptoms of depression and trait anxiety.

Conclusions

Elevated depression and anxiety are frequent among pregnant women. The results draw attention to the need for early detection and treatment of depression and anxiety during pregnancy.     

Low birthweight at term and the timing of fetal exposure to maternal smoking.

OBJECTIVES. This study was undertaken to evaluate the risk of small-for-gestational-age birth for women who stop smoking or begin to smoke during pregnancy. METHODS. Women with term singleton pregnancies from a hospital-based cohort of 11,177 were classified as (1) nonsmokers; (2) smoked throughout pregnancy; (3) smoked during first trimester only; (4) smoked during first and second trimesters only; and (5) smoked during second and third trimesters or during third trimester only. Risk of small-for-gestational-age birth according to smoking category was estimated and adjusted for confounding factors by logistic regression. RESULTS. Women who stopped smoking by the third trimester were not at increased risk of small-for-gestational-age birth compared with nonsmokers. Women who began smoking during the second or third trimester had an elevated risk of small-for-gestational-age birth (odds ratio [OR] = 1.83; 95% confidence interval [CI] = 1.25, 2.67) similar to that for women who smoked throughout pregnancy (OR = 2.20; 95% CI = 1.90, 2.54). Risk of small-for-gestational-age birth increased with the number of cigarettes smoked during the third trimester. CONCLUSIONS. It is during the third trimester that smoking retards fetal growth, presenting a compelling opportunity for smoking cessation interventions. Programs must emphasize the importance of not resuming smoking late in pregnancy.     

Psychopathological Symptoms and Locus of Control in Women with Low-Risk Pregnancies

This study investigated the role of locus of control in the development of psychopathological symptoms during pregnancy and postpartum in women with low-risk pregnancies. Pregnant women participated during the first trimester of pregnancy (n = 285), third trimester (n = 122), and in the postpartum (n = 116). Participants were assessed for locus of control (first and third trimesters) and psychopathological symptoms (first and third trimesters and postpartum). Sociodemographic and pregnancy variables (previous childbirth, previous miscarriage, and whether the pregnancy was planned) were also assessed. Significant differences were observed in the development of somatization and obsessive-compulsive symptoms during pregnancy and postpartum. Both increased in the third trimester and decreased after delivery. Previous births, planned pregnancy, having a job, and increasing age were protective variables. As pregnancy progressed, locus of control was significantly externalized. In the first trimester, significant differences were found for locus of control (internal vs. external) among almost all the psychopathological symptoms, but in the third trimester, significant differences were only found in obsessive-compulsiveness and interpersonal sensitivity. In two trimesters, internal locus of control was a protective health variable. Regression analysis showed that external locus of control was related only to phobic anxiety in the third trimester. Adoption of a bio-psycho-social model, such as internal locus of control, may increase personal resources in pregnant women.     

Quality of life in pregnancy and post-partum: a study in diabetic patients

Purpose

We evaluated quality of life in pregnant women with diabetes followed up at Italian diabetes clinics.

Methods

A total of 245 pregnant women (30 type 1 diabetes mellitus (T1DM), 176 gestational diabetes (GDM) and 39 controls) were asked to fill in a questionnaire including the SF-36 Health Survey and the Center for Epidemiological Studies-Depression (CES-D) Scale in third trimester of pregnancy and after delivery. GDM and T1DM also completed two diabetes-specific questionnaires (Diabetes-related stress and Diabetes health distress). Quality of life scores were compared between the groups with the Mann?CWhitney U-test, mean changes in scores (after delivery to 3rd trimester) were compared between groups by ANCOVA.

Results

Regarding the SF-36 scores in the third trimester of pregnancy, T1DM and GDM women had a better Standardised Physical Component score than controls (P?P?=?0.009, respectively). GDM and T1DM pregnant women scored significantly lower for general health perception than controls (P?=?0.009 and P?=?0.001, respectively). T1DM patients had lower Standardised Mental Component scores than controls (P?=?0.03). Compared with the third trimester of pregnancy, the severity of depressive symptoms increased significantly after delivery in both diabetic groups, but not in controls (P?Conclusions Pregnancy is associated with a perception of poor general health in women with both T1DM and GDM. After delivery, significantly worse depressive symptoms were documented in both groups, while a generally worse physical and psychological well-being was only identified in women with T1DM. These findings have important implications for pregnancy follow-up.     

Trait anxiety in pregnant women predicts offspring birth outcomes

The goal of our study was to characterise the relationships between trait anxiety symptoms of women during their pregnancies and birth outcomes of their offspring using a longitudinal cohort from the Maternal Health Practices and Child Development Project. We used the State-Trait Personality Index anxiety measure that is based on Spielberger's State-Trait Anxiety Inventory to measure self-reported trait anxiety at two gestational assessments (fourth and seventh months, representing the first and second trimesters, respectively) and at a third assessment shortly after delivery (representing the third trimester). Demographic, social, psychological, substance use and medical factors were assessed prenatally, and outcomes of the 763 live, singleton births were determined at delivery.
In regression models, trait anxiety at the second and third trimesters predicted lower birthweight and shorter birth length, controlling for confounders. Anxiety reported at the third trimester predicted shortened gestational age, controlling for confounders. At the first and second trimesters, the relationship of birthweight and birth length to maternal trait anxiety was only significant for severe anxiety. Women whose anxiety reached severe levels for at least two trimesters were significantly more likely to deliver offspring of lower birthweight and shorter birth length than those women who reported severe anxiety at none or only one of the trimesters. Additionally, offspring of women who experienced severe anxiety during all three trimesters had shorter mean gestational age than offspring of women who did not report severe anxiety at any trimester. Women who report chronic, severe trait anxiety are at the highest risk of having shorter gestations and delivering smaller babies.     

A cross sectional study of maternal iron status of Korean women during pregnancy

The purpose of this study was to determine the iron status of Korean women during pregnancy and to assess the relationship between maternal iron status and the outcome of their newborns. A total of eighty-one pregnant women living in Gwangju, Korea, participated in the study: 26 women were in the first trimester, 23 in the second trimester, and 32 in the third trimester. Maternal red blood cell (RBC) number, hemoglobin (Hb) concentration, and serum iron and ferritin levels were reduced significantly in the last trimester (p < 0.05) compared to the findings both in the first and second trimesters. On the other hand, total iron binding capacity (TIBC), transferrin level, and the ratio of sTfR to ferritin in the third trimester were higher (p < 0.05) than those both in the first and second trimesters. Dietary intake of iron in the three trimesters was 9.7 ± 2.3, 13.3 ± 4.3, and 10.6 ± 2.5 mg/day, respectively. All were far below the Korean Recommended Dietary Allowances (RDA) of iron for pregnant women. Approximately, ninety percent of the subjects consumed iron supplements after the 20th week of their pregnancies until delivery. The supplemental iron intake in the second and third trimesters was 40 ± 12 and 46 ± 11 mg/day, respectively. There was a significant correlation between the maternal Hb level in the third trimester and the birth weight of infants. In conclusion, maternal iron status deteriorated during pregnancy, although most subjects consumed more than the RDA of iron by taking iron supplements after the 20th week of pregnancy. The results confirm that maternal iron deficiency during pregnancy negatively affects the outcome of newborns.     

Variation in newborn size according to pregnancy weight change by trimester

BACKGROUND: The timing of maternal weight change in pregnancy may be an important determinant of the newborn's size. OBJECTIVE: The purpose was to identify effects of maternal weight change by trimester on newborn size, under the hypothesis that low weight gain early in pregnancy predicts proportionately smaller newborns. DESIGN: Women planning to become pregnant were followed by clinic visits and questionnaires through delivery. This study includes 389 women and their singleton infants born at a gestational age of > or = 241 d. RESULTS: In multiple regression analyses including a variety of potential confounders, maternal weight gain in the first and second trimesters predicted newborn weight (1-kg weight gain in the first trimester predicted a 31-g increase in newborn weight, P < 0.0007, and 1-kg weight gain in the second trimester predicted a 26-g increase in newborn weight, P < 0.007), but weight gain in the third trimester did not. Newborn ponderal index (in kg/m(3)) was predicted by weight gain in the first (1-kg weight gain predicted an added 0.21 units, P < 0.0003) and third (1-kg weight gain predicted an added 0.12 units, P < 0.03) trimesters but not in the second trimester. Newborn weight was 211 g lower (P < 0.006) and ponderal index 1.2 units lower (P < 0.02) in infants born to women who lost weight in the first trimester. CONCLUSIONS: The use of measured prepregnancy weight in tests of the effect on newborn size of weight gain by time in pregnancy produces different results than does the use of recalled prepregnancy weight. Maternal weight change in the first trimester of pregnancy more strongly influences newborn size than does weight change in the second or third trimester.     

Pregnancy increases urinary loss of carnitine and reduces plasma carnitine in Korean women

This study compared plasma and urinary carnitine concentrations in pregnant and non-pregnant Korean women. The subjects were fifty pregnant women and thirty non-pregnant women aged 24-28 years. During the first trimester, dietary carnitine intakes in the pregnant women were much lower than in non-pregnant women (70.00 (SD 29.22) micromol/d), but over the course of pregnancy carnitine intake increased from 44.64 (SD 24.84) micromol/d during the first trimester to 96.11 (SD 36.56) micromol/d during the third trimester. Pregnant women had a significantly lower plasma carnitine concentration than non-pregnant women. Plasma concentrations of non-esterified carnitine, acid-soluble acylcarnitine and total carnitine were significantly lower during the second and third trimesters than the first. Plasma acid-insoluble acylcarnitine levels, which tended to be higher in the non-pregnant women compared with the pregnant women, increased significantly as gestation proceeded. The urinary excretion of non-esterified carnitine, acid-soluble acylcarnitine and total carnitine was significantly higher in the pregnant women during the first and second trimesters than in non-pregnant women and decreased significantly as gestation proceeded. We found that there was a significant decrease in plasma carnitine level even though dietary carnitine intake increased as gestation proceeded. The low urinary excretion of carnitine in late pregnancy may be caused by an increased demand during pregnancy.     

Hemoglobin Concentration during Early Pregnancy as an Accurate Predictor of Anemia during Late Pregnancy

It is undetermined which blood variables related to iron storage during the first trimester of pregnancy could efficiently predict anemia occurring during the third trimester. Red blood cell count (RBC), hemoglobin concentration, hematocrit, ferritin, iron, and total iron binding capacity (TIBC) were assessed longitudinally during the first, second, and third trimesters of 231 healthy Japanese women. None of the patients had anemia in the first trimester and none used iron supplementation before the second trimester blood test. Anemia was defined as hemoglobin (Hb) < 11 g/dL for the first trimester and Hb < 10.0 g/dL for the third trimester. Forty-seven (20%) women developed anemia in the third trimester. The first trimester RBC, Hb, hematocrit, and ferritin levels were significantly lower in women with third-trimester anemia than those without anemia. The first trimester hemoglobin level exhibited a greater area under the curve of the receiver operating characteristic curve for prediction of the third trimester anemia than other blood variables; the optimal cut-off (12.6 g/dL) of hemoglobin yielded a sensitivity of 83% (39/47). First trimester hemoglobin levels were significantly better predictors of anemia during the third trimester than the indices of iron storage, including serum iron, ferritin, and TIBC levels.     

妊娠期肝内胆汁淤积症对分娩结局影响的出生队列研究

目的 探讨孕中期和孕晚期妊娠期肝内胆汁淤积症(ICP)对分娩结局的影响。方法 在马鞍山市优生优育队列(MABC)中,将孕周≤14周、符合入组标准的孕妇共3 474人纳入队列,在首次产检时收集孕妇的一般人口学信息,并收集孕中期和孕晚期血清总胆汁酸(TBA)的检测结果,符合临床诊断的作为病例,采用logistic回归分析孕中期和孕晚期ICP对分娩结局的影响。结果 最终分析的样本人数为2 978人,ICP发生率为6.5%(n=196),其中孕中期和孕晚期ICP发生率分别为1.4%(n=43)和5.1%(n=153)。控制了潜在的混杂因素后,孕中期和孕晚期ICP均增加胎儿早产、低出生体重(LBW)、胎儿窘迫和羊水粪染的风险,OR值(95% CI)分别为6.42(2.59~15.93)和3.73(2.07~6.72);6.52(2.19~19.45)和4.90(2.43~9.90);2.91(1.27~6.67)和1.88(1.11~3.19);2.34(1.19~4.61)和1.66(1.11~2.48),并且孕中期ICP组发生上述不良分娩结局的风险远远高于孕晚期ICP组。结论 孕中期和孕晚期ICP均显著增加胎儿不良分娩结局的风险,孕中期ICP尤其值得关注,早期发现和干预对降低不良分娩结局的发生意义重大。     

Screening for depression during pregnancy using the Kurdish version of the Edinburgh Postnatal Depression Scale in Erbil city

Abstract

We aimed to determine any difference in the prevalence rate of depression during the three trimesters of pregnancy and its association with certain obstetric risk factors. In total, 1000 pregnant women attending primary health centers in the city of Erbil, Kurdistan, Iraq were assessed for depression using the Edinburgh Postnatal Depression Scale. Women in the first and second trimesters had a significantly higher probability of depression than those in the third trimester. Screening early in pregnancy and following pregnant women in each trimester may help to identify those who are susceptible to depression and enable appropriate intervention.     

TPO和MPV在孕妇血液高凝状态评价中的意义

目的:探讨促血小板生成素(TPO)和平均血小板体积(MPV)在评价孕妇高凝状态中的应用价值。方法:检测41例健康孕妇在早孕期、中孕期和晚孕期的TPO、MPV、抗凝血酶-3(AT-3)、纤维蛋白原(FIB)、D-二聚体(D-D)和血小板聚集率(PAR)水平,计算孕妇各指标的阳性率,并分析TPO、MPV和其余指标间的相关性;同时选取30例健康非孕妇女为正常对照组。结果:妊娠组中孕期TPO和MPV显著高于早孕期和对照组,晚孕期二者水平显著高于中孕期(P<0.01);中孕期AT-Ⅲ、FIB、D-D和PAR水平与早孕期比较无统计学差异(P>0.05),晚孕期FIB、D-D和PAR水平显著高于中孕期,AT-Ⅲ水平显著低于中孕期(P<0.001)。TPO与MPV呈显著正相关;TPO和MPV与AT-Ⅲ呈显著负相关,与FIB、D-D和PAR呈显著正相关(P<0.01)。中孕期TPO、MPV、AT-Ⅲ、FIB、D-D、PAR和TPO+MPV阳性率显著高于早孕期,晚孕期各指标阳性率均显著高于中孕期(P<0.01)。中孕期和晚孕期TPO、MPV的阳性率均显著高于AT-Ⅲ、D-D和PAR阳性率,不同孕期TPO+MPV的阳性率均显著高于其余4个指标的阳性率(P<0.01)。结论:TPO和MPV可能是导致孕妇血液高凝状态的更重要因素,联合测定TPO和MPV在监测孕妇围产期高凝状态的发展和预防血栓形成中具有重要的价值。     

Impact of a Health Promotion Intervention on Maternal Depressive Symptoms at 15?months Postpartum

Given that diet, physical activity, and social support are associated with depression, we examined whether a health promotion intervention designed to modify these factors in low-income, postpartum women would reduce depressive symptoms. This study used a randomized, controlled design to examine the effect of the Just for You (JFY) Program, an educational intervention promoting healthy lifestyles through home visits by nutrition paraprofessionals and motivational telephone counseling, on postpartum depressive symptoms. A total of 679 women income-eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were recruited at 6-20 weeks post delivery and randomized to Usual WIC Care or JFY. Using an intention-to-treat analysis, the authors modeled depressive symptoms on the Center for Epidemiologic Studies Depression Scale (CES-D) among 403 women (59%) completing follow-up at a mean of 15 months infant age, adjusting for baseline CES-D, age, household income and randomization strata (body mass index (BMI), race/region). As a secondary analysis, the authors evaluated potential mediators related to social support and self-efficacy to change one or more health behaviors targeted by the intervention. Women randomized to JFY reported 2.5 units lower CES-D score (P = 0.046) compared with those receiving Usual WIC Care alone. This relationship was attenuated by change in self-efficacy (β = −2.3; P = 0.065), suggesting this construct may partially have mediated the effect of JFY on maternal depressive symptoms. A health promotion intervention delivered through home visits and telephone calls can reduce depressive symptoms at 15 months postpartum among low-income, ethnically diverse women.     

Determinants of depressive symptoms in the early weeks after miscarriage.

OBJECTIVES. We tested whether and under what conditions miscarriage increases depressive symptoms in the early weeks following loss. METHODS. We interviewed 232 women within 4 weeks of miscarriage and 283 pregnant women and 318 community women who had not recently been pregnant. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) Scale. RESULTS. Among women who had miscarried, the proportion who were highly symptomatic on the CES-D was 3.4 times that of pregnant women and 4.3 times that of community women. Among childless women, the proportion of women who had miscarried who were highly symptomatic was 5.7 times that of pregnant women and 11.0 times that of community women. Women who had miscarried were equally depressed regardless of length of gestation; among pregnant women, depressive symptoms declined with length of gestation. Among women who had miscarried, symptom levels did not vary with attitude toward the pregnancy; among pregnant women, depressive symptoms were elevated in those with unwanted pregnancies. Prior reproductive loss and advanced maternal age (35+ years) were not associated with symptom levels in any cohort. CONCLUSIONS. Depressive symptoms are markedly increased in the early weeks following miscarriage. This effect is substantially modified by number of living children, length of gestation at loss, and attitude toward pregnancy.     

妊娠意愿与孕中晚期妊娠相关焦虑关联的队列研究

目的 探讨妊娠意愿与孕中、晚期妊娠相关焦虑关联及其强度。方法 在马鞍山优生优育队列（MABC）中,将孕周≤ 14周、符合纳入标准的3 474名孕妇纳入队列。在首次产检时收集孕妇的一般人口学信息,并在孕中期和孕晚期收集妊娠相关焦虑量表。采用logistic回归分析妊娠意愿对孕中期和孕晚期妊娠相关焦虑的影响。结果 最终3 083人纳入分析,意外妊娠检出率为15.00%（n=461）。孕中期和孕晚期妊娠相关焦虑检出率分别为29.13%（n=898）、30.36%（n=936）。控制潜在的混杂因素后,与有充分思想准备的孕妇相比,意外妊娠的孕妇孕中期出现妊娠相关焦虑的风险增加（OR=1.85,95%CI：1.44~2.38）;孕晚期出现妊娠相关焦虑的风险也增加（OR=1.84,95%CI：1.44~2.35）;顺其自然怀孕的孕妇在孕中、晚期未增加妊娠相关焦虑发生风险。结论 意外妊娠是孕中、晚期妊娠相关焦虑危险因素。     

Changes in Sleep Patterns during Pregnancy and Predictive Factors: A Longitudinal Study in Saudi Women

This study aimed to assess sleep patterns during the three trimesters of pregnancy and whether vitamin D concentrations, along with other risk factors, are associated with these alterations. In a longitudinal study, 140 pregnant women (age 18 to 39 years) were followed throughout their first, second, and third trimesters. Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) at each trimester, along with an assessment of biochemical parameters, including serum vitamin D levels. The information that was collected included anthropometric data, socio-economic status, dietary intake, and physical activity. The PSQI was higher in mid and late pregnancy than in early pregnancy (both p = 0.001), and the sleep duration was also higher in late versus early pregnancy. Linear regression analyses revealed independent predictors of deteriorating sleep quality from early to late pregnancy, including low income (B ± SE −0.60 ± 0.26, p = 0.03) and low serum vitamin D levels in the second trimester (B ± SE −0.20 ± 0.01, p = 0.04). Energy intake and sitting in the second half of pregnancy were positively associated with changes in the PSQI score from the second to third trimesters (B ± SE 0.15 ± 0.07, p = 0.048) and (B ± SE 0.01 ± 0.00, p = 0.044), respectively. Low socio-economic status, low serum vitamin D levels, greater energy intake, and sitting time were associated with worsening patterns of sleep quality from early to late pregnancy.     

Relationship of perceived job strain and workplace support to antenatal depressive symptoms among pregnant employees in Taiwan

Most Taiwanese women continue to work throughout pregnancy. Few studies have investigated the prevalence of antenatal depressive symptoms in employed women and their relationship with work-related factors. We explored the relations of work-related factors, including perceived job strain and workplace support, to depressive symptoms among pregnant Taiwanese employees. During 2015–2016, we interviewed 153 employees in their third trimester of pregnancy using questionnaires to collect data on demographics, pregnancy status, physical conditions, work-related factors, family function, the Edinburgh Postnatal Depression Scale (EPDS), and health-related quality of life (HRQoL). The prevalence of antenatal depressive symptoms, based on EPDS scores≥13, was 13.7%. Pregnant employees with depressive symptoms had lower Family APGAR scores (p < 0.0001) and lower scores on all scales of the HRQoL (p < 0.05). Controlling for covariates, work-related feelings of stress and distress were associated with increased odds of antenatal depressive symptoms (Odds Ratio [OR] = 4.7, 95% confidence Interval [95% CI] = 1.3–19.9). Feeling tired at work (OR = 9.1, 95% CI = 2.3–47.0) and lack of support from colleagues (OR = 16.7, 95% CI = 2.9–53.1) were significantly associated with antenatal depressive symptoms. Such information will facilitate implementation of supportive workplace climates for pregnant employees by employers, supervisors, and occupational and environmental health nurses, which may help improve the health of pregnant employees.