Maternal and Child Health Journal

, Volume 21, Issue 4, pp 942–952 | Cite as

Depression During Pregnancy and Adverse Birth Outcomes Among Predominantly Puerto Rican Women

  • Kathleen SzegdaEmail author
  • Elizabeth R. Bertone-Johnson
  • Penelope Pekow
  • Sally Powers
  • Glenn Markenson
  • Nancy Dole
  • Lisa Chasan-Taber


Objectives To examine associations between depression and preterm birth and small-for gestational age (SGA) among women of predominantly Puerto Rican descent, a population who experiences disparities in adverse birth outcomes and one of the highest infant mortality rates in the United States. Methods Proyecto Buena Salud (PBS) was a prospective cohort study conducted from 2006 to 2011 at a large tertiary care center in Western Massachusetts. Caribbean Islander (i.e., Puerto Rican and Dominican Republic) women were interviewed in early, mid and late pregnancy. Among 1262 participants, associations between depression, assessed using the Edinburgh Postnatal Depression Scale, and risk of preterm birth and small-for-gestational age (SGA) were evaluated. Results Women with at least probable minor depression [odds ratio (OR) = 1.77 (95% confidence interval (CI) = 1.02, 3.07)] or probable major depression [OR = 1.82 (95% CI = 1.01, 3.25)] in mid-pregnancy had an increased risk of SGA compared to non-depressed women in adjusted analyses. Borderline significant associations were observed between increasing levels of depressive symptom scores in early and mid-pregnancy [OR = 1.05 (95% CI = 1.00, 1.11) and OR = 1.04 (95% CI = 1.00, 1.09), respectively] and each additional trimester of exposure to probable major depression across mid- to late pregnancy [OR = 1.66 (95% CI = 1.00, 2.74)] and SGA. Late pregnancy depression was not associated with SGA; depression during pregnancy was not associated with preterm birth. Conclusions for Practice In this population of predominantly Puerto Rican women, mid-pregnancy depression increased risk for SGA. Findings can inform culturally appropriate, targeted interventions to identify and treat pregnant women with depression.


Prenatal depression Preterm birth Small-for-gestational age Birth outcomes Latina perinatal health 


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kathleen Szegda
    • 1
    Email author
  • Elizabeth R. Bertone-Johnson
    • 1
  • Penelope Pekow
    • 1
  • Sally Powers
    • 2
  • Glenn Markenson
    • 3
  • Nancy Dole
    • 4
  • Lisa Chasan-Taber
    • 1
  1. 1.Department of Biostatistics and Epidemiology, School of Public Health and Health SciencesUniversity of MassachusettsAmherstUSA
  2. 2.Department of Psychological and Brain SciencesUniversity of MassachusettsAmherstUSA
  3. 3.Baystate Medical CenterSpringfieldUSA
  4. 4.Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillUSA

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