Maternal and Child Health Journal

, Volume 19, Issue 10, pp 2179–2186

Depressive Symptoms Prior to Pregnancy and Infant Low Birth Weight in South Africa

  • Andrew Tomita
  • Charlotte A. Labys
  • Jonathan K. Burns
Article

Abstract

Despite improvements in service delivery and patient management, low birth weight among infants has been a persistent challenge in South Africa. The study aimed to explore the relationship between depression before pregnancy and the low birth weight (LBW) of infants in post-apartheid South Africa. This study utilized data from Waves 1 and 2 of the South African National Income Dynamics Study, the main outcome being a dichotomous measure of child LBW (<2500 g) drawn from the Wave 2 child questionnaire. Depressive symptoms of non-pregnant women was the main predictor drawn from the Wave 1 adult questionnaire. Depressive symptoms were screened using the 10-item four-point Likert version of the Center for Epidemiologic Studies Depression Scale (CES-D) instrument. A total score of 10 or greater on the CES-D indicates a positive screen for depressive symptoms. An adjusted logistic regression model was used to examine the relationship between women’s depression before pregnancy and infant LBW. A sample size of 651 women in Wave 1 was linked to 672 newborns in Wave 2. The results of the adjusted logistic regression model indicated depressive symptoms (CES-D ≥ 10) prior to pregnancy were associated with infant LBW (adjusted OR 2.84, 95 % CI 1.08–7.46). Another significant covariate in the model was multiple childbirths. Our finding indicates that women’s depressive symptoms prior to pregnancy are associated with the low birth weight of newborns and suggests that this association may not be limited to depression present during the ante-natal phase.

Keywords

Depression prior to pregnancy Low birth weight South Africa 

References

  1. 1.
    Goldenberg, R. L., & Culhane, J. F. (2007). Low birth weight in the United States. American Journal of Clinical Nutrition, 85(2), 584S–590S.PubMedGoogle Scholar
  2. 2.
    Vigod, S. N., Villegas, L., Dennis, C. L., et al. (2010). Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review. BJOG, 117(5), 540–550.CrossRefPubMedGoogle Scholar
  3. 3.
    Chopra, M., Daviaud, E., Pattinson, R., et al. (2009). Saving the lives of South Africa’s mothers, babies, and children: Can the health system deliver? Lancet, 374(9692), 835–846.CrossRefPubMedGoogle Scholar
  4. 4.
    Organisation for Economic Cooperation and Development. (2011). Infant health: Low birth weight. http://dx.doi.org/10.1787/health_glance-2011-11-en
  5. 5.
    Zimmer-Gembeck, M. J., & Helfand, M. (1996). Low birthweight in a public prenatal care program: Behavioral and psychosocial risk factors and psychosocial intervention. Social Science and Medicine, 43(2), 187–197.CrossRefPubMedGoogle Scholar
  6. 6.
    Teitler, J. O., Reichman, N. E., Nepomnyaschy, L., et al. (2007). A cross-national comparison of racial and ethnic disparities in low birth weight in the United States and England. Pediatrics, 120(5), e1182–e1189.CrossRefGoogle Scholar
  7. 7.
    Khoshnood, B., Wall, S., & Lee, K. S. (2005). Risk of low birth weight associated with advanced maternal age among four ethnic groups in the United States. Maternal Child Health Journal, 9(1), 3–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Blondel, B., Kogan, M. D., Alexander, G. R., et al. (2002). The impact of the increasing number of multiple births on the rates of preterm birth and low birthweight: An international study. American Journal of Public Health, 92(8), 1323–1330.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Odell, C. D., Kotelchuck, M., Chetty, V. K., et al. (2006). Maternal hypertension as a risk factor for low birth weight infants: Comparison of Haitian and African-American women. Maternal Child Health Journal, 10(1), 39–46.CrossRefPubMedGoogle Scholar
  10. 10.
    Abu-Ghanem, S., Sheiner, E., Sherf, M., et al. (2012). Lack of prenatal care in a traditional community: Trends and perinatal outcomes. Archives of Gynecology and Obstetrics, 285(5), 1237–1242.CrossRefPubMedGoogle Scholar
  11. 11.
    Manikkam, L., & Burns, J. K. (2012). Antenatal depression and its risk factors: An urban prevalence study in KwaZulu-Natal. South African Medical Journal, 102(12), 940–944.PubMedGoogle Scholar
  12. 12.
    Grote, N. K., Bridge, J. A., Gavin, A. R., et al. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67(10), 1012–1024.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Brennan, P. A., Hammen, C., Andersen, M. J., et al. (2000). Chronicity, severity, and timing of maternal depressive symptoms: Relationships with child outcomes at age 5. Developmental Psychology, 36(6), 759–766.CrossRefPubMedGoogle Scholar
  14. 14.
    Marcus, S. M., Flynn, H. A., Blow, F. C., et al. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women’s Health, 12(4), 373–380.CrossRefPubMedGoogle Scholar
  15. 15.
    Dietz, P. M., Williams, S. B., Callaghan, W. M., et al. (2007). Clinically identified maternal depression before, during, and after pregnancies ending in live births. American Journal of Psychiatry, 164(10), 1515–1520.CrossRefPubMedGoogle Scholar
  16. 16.
    Petersen, I., & Lund, C. (2011). Mental health service delivery in South Africa from 2000 to 2010: One step forward, one step back. South African Medical Journal, 101(10), 751–757.PubMedGoogle Scholar
  17. 17.
    Class, Q. A., Khashan, A. S., Lichtenstein, P., et al. (2013). Maternal stress and infant mortality: The importance of the preconception period. Psychological Science, 24(7), 1309–1316.PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    Witt, W. P., Wisk, L. E., Cheng, E. R., et al. (2012). Preconception mental health predicts pregnancy complications and adverse birth outcomes: A national population-based study. Maternal and Child Health Journal, 16(7), 1525–1541.PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Radloff, L. S. (1977). The CES-D scale. Applied Psychological Measurement, 1(3), 385–401.CrossRefGoogle Scholar
  20. 20.
    Bjorgvinsson, T., Kertz, S. J., Bigda-Peyton, J. S., et al. (2013). Psychometric properties of the CES-D-10 in a psychiatric sample. Assessment, 20(4), 429–436.CrossRefPubMedGoogle Scholar
  21. 21.
    Andresen, E. M., Malmgren, J. A., Carter, W. B., et al. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10(2), 77–84.PubMedGoogle Scholar
  22. 22.
    Rao, J. N. K., & Scott, A. J. (1984). On Chi-squared tests for multiway contingency tables with cell proportions estimated from survey data. Annals of Statistics, 12(1), 46–60.CrossRefGoogle Scholar
  23. 23.
    Joyce, K., Diffenbacher, G., Greene, J., & Sorokin, Y. (1984). Internal and external barriers to obtaining prenatal care. Social Work in Health Care, 9(2), 89–96.CrossRefGoogle Scholar
  24. 24.
    Kopelman, R. C., Moel, J., Mertens, C., et al. (2008). Barriers to care for antenatal depression. Psychiatric Services, 59(4), 429–432.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Myer, L., & Harrison, A. (2003). Why do women seek antenatal care late? Perspectives from rural South Africa. Journal of Midwifery & Women’s Health, 48(4), 268–272.CrossRefGoogle Scholar
  26. 26.
    Jesse, D. E., Dolbier, C. L., & Blanchard, A. (2008). Barriers to seeking help and treatment suggestions for prenatal depressive symptoms: Focus groups with rural low-income women. Issues in Mental Health Nursing, 29(1), 3–19.CrossRefPubMedGoogle Scholar
  27. 27.
    Kramer, M. S., Séguin, L., Lydon, J., et al. (2000). Socio-economic disparities in pregnancy outcome: Why do the poor fare so poorly? Paediatric and Perinatal Epidemiology, 14(3), 194–210.CrossRefPubMedGoogle Scholar
  28. 28.
    Institute of Medicine. (1985). Preventing low birthweight. http://www.ncbi.nlm.nih.gov/books/NBK214468/pdf/TOC.pdf
  29. 29.
    Krans, E. E., & Davis, M. M. (2012). Preventing low birthweight: 25 years, prenatal risk, and the failure to reinvent prenatal care. American Journal of Obstetrics and Gynecology, 206(5), 398–403.CrossRefPubMedGoogle Scholar
  30. 30.
    Statistics South Africa. (2004). Concept and definitions. Pretoria: Statistics South Africa.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Andrew Tomita
    • 1
    • 2
  • Charlotte A. Labys
    • 1
  • Jonathan K. Burns
    • 1
  1. 1.Department of Psychiatry, Nelson R. Mandela School of MedicineUniversity of KwaZulu-NatalCongella, DurbanSouth Africa
  2. 2.Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkUSA

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