Maternal Depressive Symptoms, Perceived Stress, and Fetal Growth

Abstract

Objectives: To determine whether longitudinal fetal growth is altered among pregnant women reporting greater perceived stress or more symptoms of depression.

Methods: This analysis was based on a multicenter longitudinal study of fetal growth. Women were screened at gestational ages of 8 weeks to 13 weeks 6 days for low-risk status and underwent serial sonographic examinations. At each study visit during pregnancy, women were asked to complete the Cohen Perceived Stress Scale (PSS) and Edinburgh Postpartum Depression Survey (EPDS). Growth curves for estimated fetal weight and individual biometric parameters were created by using linear mixed models with cubic splines and compared on the basis of whether women scored 15 or higher on the PSS or 10 or higher on the EPDS either at the start of or at any time during pregnancy.

Results: Of the 2334 women enrolled in the study, 2088 (89%) and 2108 (90%) completed the PSS and EPDS, respectively, at least once in all trimesters. The longitudinal growth curves of estimated fetal weight as well as all individual biometric parameters were similar (P > .05) regardless of whether the participants reported PSS of 15 or higher or EPDS of 10 or higher in the first trimester or whether these scores persisted throughout the pregnancy. Similarly, effect modification by race/ethnicity was not statistically significant for the biometric parameters under study (P > .05 for all race/ethnicity interactions).

Conclusions: More depressive symptoms and greater perceived stress, as quantified by the EPDS and the PSS, respectively, are not associated with alterations in fetal growth throughout gestation.

Keywords: depression; fetal growth; obstetric ultrasound; psychosocial; stress.

Figure 1

Fetal growth trajectories for estimated fetal weight (EFW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) based a PSS score of 15 or higher.

Figure 2

Fetal growth trajectories for estimated fetal weight (EFW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) based on an EPDS score of 10 or higher.

Figure 3

Fetal growth trajectories for estimated fetal weight (EFW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) based on a PSS score of 15 or higher always versus intermittently versus never during pregnancy.

Figure 4

Fetal growth trajectories for estimated fetal weight (EFW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) based on an EPDS score of 10 or higher always versus intermittently versus never during pregnancy.