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Psychosom Med. 2010 Oct;72(8):769-76. doi: 10.1097/PSY.0b013e3181ee4a62. Epub 2010 Jul 28.

Maternal depressive symptoms in relation to perinatal mortality and morbidity: results from a large multiethnic cohort study.

Author information

1
Utrecht University, IRAS, Department of Environmental Epidemiology, Jenalaan 18d, 3584 CK Utrecht, the Netherlands. g.goedhart@uu.nl

Abstract

OBJECTIVE:

To explore whether 1) maternal depressive symptoms during pregnancy are associated with preterm birth (PTB), small for gestational age (SGA), a low Apgar score and child loss; 2) maternal smoking mediates the associations; and 3) the associations differ by ethnic background.

METHODS:

Pregnant women in Amsterdam were approached during their first prenatal visit to participate in the Amsterdam Born Children and their Development study. They filled out a questionnaire covering sociodemographic data, life-style, and (psychosocial) health. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression scale. The baseline sample consisted of 8,052 women; the main ethnic groups were: Dutch, Creole, Turkish, and Moroccan.

RESULTS:

The prevalence of perinatal outcomes was: 5.4% (PTB); 12.3% (SGA); l 1.5% (low Apgar score); and 1.4% (child loss). The prevalence of high depressive symptomatology was 30.6%. After adjustment for maternal age, parity, education, ethnicity, prepregnancy body mass index, hypertension, alcohol and drug use, and a small mediation effect of maternal smoking, high versus low levels of depressive symptoms were associated with SGA (odds ratio [OR], 1.19; p = .02) and a low Apgar score (OR, 1.74; p = .01), but not with PTB (OR, 1.16; p = .18) and child loss (OR, 1.28; p = .24). Stratified analyses by ethnic background showed a tendency toward higher risks, although insignificant, among Creole women.

CONCLUSIONS:

Several pathways may explain the detrimental effects of maternal depressive symptomatology on perinatal health outcomes, including a psychoendocrinological pathway involving the hormone cortisol or mediation effects by maternal risk behaviors. Further research should explore the underlying pathways, in particular among ethnic subgroups.

PMID:
20668282
DOI:
10.1097/PSY.0b013e3181ee4a62
[Indexed for MEDLINE]
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