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The Association Between Maternal Depression During Pregnancy and Adverse Birth Outcomes: A Retrospective Cohort Study of PRAMS Participants

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Abstract

Women of reproductive age are at higher risk for depression than men; and depressive behaviors and endocrine imbalances could lead to adverse birth outcomes. The purpose of this study was to investigate whether maternal depression during pregnancy affected adverse birth outcomes, specifically preterm birth and small for gestational age (SGA). This study included 4123 women who participated in the 2009–2011 Utah Pregnancy Risk Assessment Monitoring System, an ongoing surveillance project that investigates maternal behaviors in women who have recently had a live birth. Women self-reported information on depression and outcome data were obtained from birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95 % confidence intervals (CIs). Women who self-reported a diagnosis of depression during pregnancy had statistically significant increased odds of preterm birth as compared to women who had not been diagnosed with depression (OR 1.51; 95 % CI 1.07, 2.12); there was no association between depression and SGA (OR 0.92; 95 % CI 0.63, 1.34). After adjustment for prenatal care visits, the depression–preterm birth association was attenuated and no longer statistically significant (OR 1.29; 95 % CI 0.90, 1.85). After adjustment for smoking, there continued to be no strong association between depression and SGA (OR 0.80; 95 % CI 0.54, 1.20). The findings of this study do not support a maternal depression–adverse birth outcomes relationship among a predominantly healthy population of non-Hispanic White, well educated women. Future studies should focus on other diverse populations of women to determine if there is an association for these subgroups.

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Abbreviations

SGA:

Small for gestational age

NICU:

Neonatal intensive care unit

HPA:

Hypothalamic–pituitary–adrenal

PRAMS:

Pregnancy Risk Assessment Monitoring Systems

CDC:

Centers for Disease Control and Prevention

OR:

Odds ratio

CI:

Confidence interval

CIS-R:

Clinical interview schedule revised

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223-0001, USA

    Kenesha F. Smith, Larissa R. Brunner Huber, L. Michele Issel & Jan Warren-Findlow

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  1. Kenesha F. Smith
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  2. Larissa R. Brunner Huber
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  3. L. Michele Issel
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Correspondence to Kenesha F. Smith.

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Smith, K.F., Huber, L.R.B., Issel, L.M. et al. The Association Between Maternal Depression During Pregnancy and Adverse Birth Outcomes: A Retrospective Cohort Study of PRAMS Participants. J Community Health 40, 984–992 (2015). https://doi.org/10.1007/s10900-015-0022-4

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