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Elevated risk of adverse obstetric outcomes in pregnant women with depression
Authors:Deborah R. Kim  Laura E. Sockol  Mary D. Sammel  Caroline Kelly  Marian Moseley  C. Neill Epperson
Affiliation:1. Department of Psychiatry and Penn Center for Women’s Behavioral Wellness, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, USA
2. Penn Center for the Study of Sex and Gender in Behavioral Health, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
3. Department of Biostatistics and Epidemiology, University of Pennsylvania, Pennsylvania, USA
4. Department of Obstetrics and Gynecology, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, USA
5. Departments of Psychiatry and Obstetrics and Gynecology; Penn Center for Women’s Behavioral Wellness, and Penn Center for the Study of Sex and Gender in Behavioral Health, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, USA
Abstract:In this study, we evaluated the association between prenatal depression symptoms adverse birth outcomes in African–American women. 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 preeclampsia, preterm birth, intrauterine growth retardation, and low birth weight. 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. Patients who screen positive for depression symptoms during pregnancy are at increased risk for multiple adverse birth outcomes. In 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, these findings should be confirmed in a prospective cohort study.
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