Abstract
The present study examined risk factors for depression during pregnancy in a very large population sample. Two research questions have been addressed: first, the association between demographic factors and past negative obstetrical outcomes on depression severity scores, and second, the differences in these factors between women recruited at a university medical center and maternal health centers (MHC). The study included more than 5,000 pregnant women attending regular appointments at the University Obstetrics and Gynecology Clinic or at several MHCs in Eastern Iowa. Participants completed a Beck depression inventory (BDI) and a demographic questionnaire. We performed a statistical analysis on the association between risk factors and depression severity scores. Regression analysis revealed that week of pregnancy, site of recruitment, years of education, income, marital status, employment, and number of miscarriages and stillbirths were significant predictors of total BDI score. Compared to their university counterparts, participants at MHCs had more depressive symptoms, were younger, mostly single, and had lower socioeconomic status and more past negative obstetrical outcomes. Our study can inform providers about some of the risk factors during depression screening in pregnancy to increase diagnostic vigilance and tailor the level of prenatal care accordingly.
Similar content being viewed by others
References
Beck A, Ward C, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:53–63
Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103(4):698–709 (Apr.) Review. Erratum in: Obstet Gynecol. 2004 103(6):1344 (Jun)
Bernazzani O, Bifulco A (2003) Motherhood as a vulnerability factor in major depression: the role of negative pregnancy experiences. Soc Sci Med 56:1249–1260
Bolton HL, Hughes PM, Turton P et al (1998) Incidence and demographic correlates of depressive symptoms during pregnancy in an inner London population. J Psychosom Obstet Gynaecol 19:202–209
Bonari L, Pinto N, Ahn E, Einarson A, Steiner M, Koren G (2004) Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726–735, Review
Bunevicius R, Kusminskas L, Bunevicius A, Nadisauskiene RJ, Jureniene K, Pop V (2009) Psychosocial risk factors for depression during pregnancy. Acta Obstet Gynecol Scand 88(5):599–605
Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. Br Med J 323:257–260
Field T, Diego M, Hernandez-Reif M (2002) Prenatal depression effects on the foetus and neonate in different ethnic and socio-economic status groups. J Reprod Infant Psychol 20:149–157
Gotlib IH, Whiffen VE, Mount JH, Milne K, Cordy NI (1989) Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. J Consult Clin Psychol 57(2):269–274
Holcomb WL Jr, Stone LS, Lustman PJ, Gavard JA, Mostello DJ (1996) Screening for depression in pregnancy: characteristics of the Beck Depression Inventory. Obstet Gynecol 88:1021–1025
Hughes PM, Turton P, Evans CDH (1999) Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: cohort study. Br Med J 318:1721–1724
Johanson R, Chapman G, Murray D, Johnson I, Cox J (2000) The North Staffordshire Maternity Hospital prospective study of pregnancy-associated depression. J Psychosom Obstet Gynaecol 21:93–97
Klein MH, Essex MJ (1995) Pregnant or depressed? The effect of overlap between symptoms of depression and somatic complaints of pregnancy on rates of major depression in the second trimester. Depression 2:308–314
Lancaster C, Gold K, Flynn H, Yoo H, Marcus S, Davis M (2010) Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 202(1):5–14
Leigh B, Milgrom J (2008) Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry 8:24
Marcus SM (2009) Depression during pregnancy: rates, risks and consequences. Motherisk Update 2008. Can J Clin Pharmacol 16(1):e15–e22, Epub 2009 Jan 22. Review
O’Hara MW (1986) Social support, life events, and depression during pregnancy and the puerperium. Arch Gen Psychiatry 43:569–573
Orr ST, Miller CA (1995) Maternal depressive symptoms and the risk of poor pregnancy outcome. Epidemiol Rev 17(1):165–171
Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R (2004) Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry 61:946–952
Rich-Edwards JW, Kleinman K, Abrams A, Harlow BL, McLaughlin TJ, Joffe H, Gillman MW (2006) Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. J Epidemiol Community Health 60(3):221–227
Salamero M, Marcos T, Gutierrez F, Rebull E (1994) Factorial study of the BDI in pregnant women. Psychol Med 24:1031–1035
Séguin L, Potvin L, St-Denis M, Loiselle J (1995) Chronic stressors, social support, and depression during pregnancy. Obstet Gynecol 85(4):583–589
Zuckerman B, Amaro H, Bauchner H, Cabral H (1989) Depressive symptoms during pregnancy: relationship to poor health behaviors. Am J Obstet Gynecol 160(5 Pt 1):1107–1111
Acknowledgements
This research was supported in part by NIMH research grant MH59688.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding authors
Rights and permissions
About this article
Cite this article
Koleva, H., Stuart, S., O’Hara, M.W. et al. Risk factors for depressive symptoms during pregnancy. Arch Womens Ment Health 14, 99–105 (2011). https://doi.org/10.1007/s00737-010-0184-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-010-0184-0