Longitudinal Study of Depressive Symptoms and Health-Related Quality of Life During Pregnancy and After Delivery: The Health Status in Pregnancy (HIP) Study
- 628 Downloads
Objective Depressive symptoms are known to affect functioning in early pregnancy. We estimated the effect of a change in depressive symptoms status on health-related quality of life (HRQoL) throughout pregnancy and after delivery. Methods Longitudinal study of 200 women. The independent variable was depressive symptoms, defined as a Center for Epidemiologic Studies Depression (CES-D) score of ≥16. The dependent variable was HRQoL from 8 domains of the Medical Outcomes Study (SF-36) Short Form. Women were categorized based on the change in CES-D score: (1) never depressed, (2) became well, (3) became depressed and (4) always depressed. A random effects model was used to (1) estimate the effect of a change in depressive symptomatology from the first to the second trimester on HRQOL in the second trimester and (2) estimate the change in depressive symptomatology from the second to the third trimester on HRQoL in the third trimester and after delivery, adjusting for covariates. Intra-individual correlations were accounted for using generalized estimating equations (GEE). Results The proportion of women with depressive symptoms was 15%, 14%, and 30% in the first, second and third trimesters, respectively, and 9% after delivery. Women who became depressed had scores in the social domains that were 10–23 points and 19–31 points lower in the second and third trimesters, respectively, compared to women with no depressive symptoms. Women who became well had scores that were 3–31 points lower, compared to women with no depressive symptoms. Conclusions Alterations in depressive symptomatology have a substantial effect on functioning during pregnancy and after delivery.
KeywordsPregnancy Depressive symptoms Health-related quality of life Longitudinal analysis
- 9.Beeghly, M., Olson, K. L., Weinberg, M. K., Pierre, S. C., Downey, N., & Tronick, E. Z. (2003). Prevalence, stability, and socio-demographic correlates of depressive symptoms in Black mothers during the first 18 months postpartum. Maternal and Child Health Journal, 7(3), 157–168. doi:10.1023/A:1025132320321.PubMedCrossRefGoogle Scholar
- 12.Cogill, S. R., Caplan, H. L., Alexandra, H., Robson, K. M., & Kumar, R. (1986). Impact of maternal postnatal depression on cognitive development of young children. British Medical Journal (Clinical Research Edition), 292(6529), 1165–1167.Google Scholar
- 15.Stewart, A. L., Greenfield, S., Hays, R. D., Wells, K., Rogers, W. H., Berry, S. D., et al. (1989). Functional status and well-being of patients with chronic conditions. Results from the medical outcomes study. Journal of the American Medical Association, 262(7), 907–913. doi:10.1001/jama.262.7.907.Google Scholar
- 16.Chen, H., Chan, Y. H. 3rd, Tan, K. H., & Lee, T. (2004). Depressive symptomatology in pregnancy––a Singaporean perspective. Social Psychiatry and Psychiatric Epidemiology, 39(12), 975–979. doi:10.1007/s00127-004-0823-8.
- 19.Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence report/technology assessment, Summ, Feb(119), 1–8.Google Scholar
- 22.Ware, J. (1993). SF-36 health survey. Manual and interpretation guide.Google Scholar
- 23.Elsenbruch, S., Benson, S., Rucke, M., Rose, M., Dudenhausen, J., Pincus-Knackstedt, M. K., et al. (2007). Social support during pregnancy: Effects on maternal depressive symptoms, smoking and pregnancy outcome. Human Reproduction (Oxford, England), 22(3), 869–877. doi:10.1093/humrep/del432.Google Scholar
- 28.Gavin, N. I. , Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and gynecology, 106(5 Pt 1), 1071–1083.Google Scholar
- 30.O’Connor, T. G., Heron, J., Golding, J., Beveridge, M., & Glover, V. (2002). Maternal antenatal anxiety and children’s behavioural/emotional problems at 4 years. Report from the avon longitudinal study of parents and children. The British Journal of Psychiatry, 180(3), 502–508. doi:10.1192/bjp.180.6.502.Google Scholar
- 34.Haas, J. S., Meneses, V., & McCormick, M. C. (1999). Outcomes and health status of socially disadvantaged women during pregnancy. Journal of Women’s Health & Gender-Based Medicine, 8(4), 547–553.Google Scholar
- 37.Bromberger, J. T., Harlow, S., Avis, N., Kravitz, H. M., & Cordal, A. (2004). Racial/ethnic differences in the prevalence of depressive symptoms among middle-aged women: The study of women’s health across the nation (SWAN). American Journal of Public Health, 94(8), 1378–1385.PubMedCrossRefGoogle Scholar