Risk factors for depressive symptoms during pregnancy

Abstract

The present study examined risk factors for depression during pregnancy in a very large population sample. Two research questions have been addressed: first, the association between demographic factors and past negative obstetrical outcomes on depression severity scores, and second, the differences in these factors between women recruited at a university medical center and maternal health centers (MHC). The study included more than 5,000 pregnant women attending regular appointments at the University Obstetrics and Gynecology Clinic or at several MHCs in Eastern Iowa. Participants completed a Beck depression inventory (BDI) and a demographic questionnaire. We performed a statistical analysis on the association between risk factors and depression severity scores. Regression analysis revealed that week of pregnancy, site of recruitment, years of education, income, marital status, employment, and number of miscarriages and stillbirths were significant predictors of total BDI score. Compared to their university counterparts, participants at MHCs had more depressive symptoms, were younger, mostly single, and had lower socioeconomic status and more past negative obstetrical outcomes. Our study can inform providers about some of the risk factors during depression screening in pregnancy to increase diagnostic vigilance and tailor the level of prenatal care accordingly.

Fig. 1

Distribution of BDI scores in the sample (count is equal to the number of cases). Darker color indicates BDI scores >16 (above threshold for clinical depression)