Maternal and Child Health Journal

, Volume 19, Issue 10, pp 2179–2186 | Cite as

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

  • Andrew TomitaEmail author
  • Charlotte A. Labys
  • Jonathan K. Burns


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.


Depression prior to pregnancy Low birth weight South Africa 



Dr. Tomita was supported by NIH Research Training Grant (R25 TW009337) funded by the Fogarty International Center and the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The data was accessed through Southern Africa Labour and Development Research Unit. National Income Dynamics Study 2008 and 2010–2011, Wave 1 and 2 (dataset). Version 4.1 for Wave 1 and version 1.0 for Wave 2. Cape Town: Southern Africa Labour and Development Research Unit (producer), 2013. Cape Town: Data First (distributor), 2013.

Conflict of interest

All authors have approved the manuscript as submitted and none of the authors have a conflict of interest to declare.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Andrew Tomita
    • 1
    • 2
    Email author
  • 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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