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Am J Perinatol 2019; 36(06): 567-573
DOI: 10.1055/s-0038-1675646
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association of Antenatal Depression with Clinical Subtypes of Preterm Birth

Kartik K. Venkatesh
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Kelly K. Ferguson
2   Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
,
Nicole A. Smith
3   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
,
David E. Cantonwine
3   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
,
Thomas F. McElrath
3   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

04 September 2018

03 October 2018

Publication Date:
14 December 2018 (online)

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Abstract

Objective To estimate the association between antenatal depression and spontaneous preterm birth (SPTB) relative to medically indicated preterm birth (MPTB).

Study Design This was a secondary analysis of a nested case–control study of preterm birth (PTB). The exposure was a clinical diagnosis of antenatal depression. The outcome was PTB at <37 weeks classified as SPTB (spontaneous labor, preterm premature rupture of membranes, placental abruption, and cervical shortening); and MPTB (preeclampsia and intrauterine growth restriction). Multinomial logistic regression models compared women without PTB versus MPTB and SPTB, adjusting for age, race, parity, tobacco use, insurance status, and prepregnancy body mass index, and history of PTB for SPTB.

Results Among 443 pregnant women, 15.6% had an SPTB and 8.6% had an MPTB, and 16% were diagnosed with antenatal depression. Women with an SPTB were three times more likely to have antenatal depression compared with women without an SPTB (adjusted odds ratio [AOR]: 2.81; 95% confidence interval [CI]: 1.40–5.63). No significant association was identified between antenatal depression and MPTB (AOR: 1.77; 95% CI: 0.67–4.62). The association between antenatal depression and SPTB did not change after adjusting the aforementioned model for a history of PTB and antidepressant use.

Conclusion Antenatal depression may differentially affect the risk of PTB through an increase in the odds of SPTB. These results have implications for future studies on prevention and treatment options for depression and PTB.

Keywords

pregnancy - depression - preterm birth

Note

This study was presented at the Society for Maternal-Fetal Medicine's 38th Annual Meeting (Dallas, TX), Poster #707.


 

  • References

  • 1 Moutquin JM. Classification and heterogeneity of preterm birth. BJOG 2003; 110 (Suppl. 20) 30-33
    CrossrefPubMedGoogle Scholar
  • 2 Ananth CV, Vintzileos AM. Epidemiology of preterm birth and its clinical subtypes. J Matern Fetal Neonatal Med 2006; 19 (12) 773-782
    CrossrefPubMedGoogle Scholar
  • 3 Preterm Birth. 2015 . Available at: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/PretermBirth.htm . Accessed March 1, 2016
    PubMed
  • 4 Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW, Fong DY. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 2007; 110 (05) 1102-1112
    CrossrefPubMedGoogle Scholar
  • 5 Bennett HAEA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004; 103 (04) 698-709
    CrossrefPubMedGoogle Scholar
  • 6 O'Connor E, Rossom RC, Henninger M, Groom HC, Burda BU. primary care screening for and treatment of depression in pregnant and postpartum women: evidence report and systematic review for the US Preventive Services Task Force. JAMA 2016; 315 (04) 388-406
    CrossrefPubMedGoogle Scholar
  • 7 Ross LE, Grigoriadis S, Mamisashvili L. , et al. Selected pregnancy and delivery outcomes after exposure to antidepressant medication: a systematic review and meta-analysis. JAMA Psychiatry 2013; 70 (04) 436-443
    CrossrefPubMedGoogle Scholar
  • 8 Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 2010; 67 (10) 1012-1024
    CrossrefPubMedGoogle Scholar
  • 9 Jarde A, Morais M, Kingston D. , et al. Neonatal outcomes in women with untreated antenatal depression compared with women without depression: a systematic review and meta-analysis. JAMA Psychiatry 2016; 73 (08) 826-837
    CrossrefPubMedGoogle Scholar
  • 10 Yonkers KA, Norwitz ER, Smith MV. , et al. Depression and serotonin reuptake inhibitor treatment as risk factors for preterm birth. Epidemiology 2012; 23 (05) 677-685
    CrossrefPubMedGoogle Scholar
  • 11 Straub H, Adams M, Kim JJ, Silver RK. Antenatal depressive symptoms increase the likelihood of preterm birth. Am J Obstet Gynecol 2012; 207 (04) 329.e1-329.e4
    CrossrefPubMedGoogle Scholar
  • 12 Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth 2015; 28 (03) 179-193
    CrossrefPubMedGoogle Scholar
  • 13 McElrath TF, Hecht JL, Dammann O. , et al; ELGAN Study Investigators. Pregnancy disorders that lead to delivery before the 28th week of gestation: an epidemiologic approach to classification. Am J Epidemiol 2008; 168 (09) 980-989
    CrossrefPubMedGoogle Scholar
  • 14 Blackmore ER, Moynihan JA, Rubinow DR, Pressman EK, Gilchrist M, O'Connor TG. Psychiatric symptoms and proinflammatory cytokines in pregnancy. Psychosom Med 2011; 73 (08) 656-663
    CrossrefPubMedGoogle Scholar
  • 15 Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 2009; 71 (02) 171-186
    CrossrefPubMedGoogle Scholar
  • 16 Christian LM, Franco A, Glaser R, Iams JD. Depressive symptoms are associated with elevated serum proinflammatory cytokines among pregnant women. Brain Behav Immun 2009; 23 (06) 750-754
    CrossrefPubMedGoogle Scholar
  • 17 Buglione-Corbett R, Deligiannidis KM, Leung K. , et al. Expression of inflammatory markers in women with perinatal depressive symptoms. Arch Women Ment Health 2018; 21 (06) 671-679
    CrossrefPubMedGoogle Scholar
  • 18 Holzman C, Senagore P, Tian Y. , et al. Maternal catecholamine levels in midpregnancy and risk of preterm delivery. Am J Epidemiol 2009; 170 (08) 1014-1024
    CrossrefPubMedGoogle Scholar
  • 19 Cripe SM, Frederick IO, Qiu C, Williams MA. Risk of preterm delivery and hypertensive disorders of pregnancy in relation to maternal co-morbid mood and migraine disorders during pregnancy. Paediatr Perinat Epidemiol 2011; 25 (02) 116-123
    CrossrefPubMedGoogle Scholar
  • 20 Thombre MK, Talge NM, Holzman C. Association between pre-pregnancy depression/anxiety symptoms and hypertensive disorders of pregnancy. J Womens Health (Larchmt) 2015; 24 (03) 228-236
    CrossrefPubMedGoogle Scholar
  • 21 Grigoriadis S, VonderPorten EH, Mamisashvili L. , et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013; 74 (04) e321-e341
    CrossrefPubMedGoogle Scholar
  • 22 Ferguson KK, McElrath TF, Meeker JD. Environmental phthalate exposure and preterm birth. JAMA Pediatr 2014; 168 (01) 61-67
    CrossrefPubMedGoogle Scholar
  • 23 McElrath TF, Lim KH, Pare E. , et al. Longitudinal evaluation of predictive value for preeclampsia of circulating angiogenic factors through pregnancy. Am J Obstet Gynecol 2012; 207 (05) 407.e1-407.e7
    CrossrefPubMedGoogle Scholar
  • 24 Venkatesh KK, Nadel H, Blewett D, Freeman MP, Kaimal AJ, Riley LE. Implementation of universal screening for depression during pregnancy: feasibility and impact on obstetric care. Am J Obstet Gynecol 2016; 215 (04) 517.e1-517.e8
    CrossrefPubMedGoogle Scholar
  • 25 Committee on Practice Bulletins—Obstetrics, The American College of Obstetricians and Gynecologists. Practice bulletin no. 130: prediction and prevention of preterm birth. Obstet Gynecol 2012; 120 (04) 964-973
    CrossrefPubMedGoogle Scholar
  • 26 Suri R, Hellemann G, Cohen L, Aquino A, Altshuler L. Saliva estriol levels in women with and without prenatal antidepressant treatment. Biol Psychiatry 2008; 64 (06) 533-537
    CrossrefPubMedGoogle Scholar
  • 27 Venkatesh KK, Riley L, Castro VM, Perlis RH, Kaimal AJ. Association of antenatal depression symptoms and antidepressant treatment with preterm birth. Obstet Gynecol 2016; 127 (05) 926-933
    CrossrefPubMedGoogle Scholar
  • 28 Dayan J, Creveuil C, Marks MN. , et al. Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med 2006; 68 (06) 938-946
    CrossrefPubMedGoogle Scholar
  • 29 Orr ST, James SA, Blackmore Prince C. Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. Am J Epidemiol 2002; 156 (09) 797-802
    CrossrefPubMedGoogle Scholar
  • 30 Shaw JG, Asch SM, Kimerling R, Frayne SM, Shaw KA, Phibbs CS. Posttraumatic stress disorder and risk of spontaneous preterm birth. Obstet Gynecol 2014; 124 (06) 1111-1119
    CrossrefPubMedGoogle Scholar
  • 31 Baer RJ, Chambers CD, Bandoli G, Jelliffe-Pawlowski LL. Risk of preterm birth by subtype among Medi-Cal participants with mental illness. Am J Obstet Gynecol 2016; 215 (04) 519.e1-519.e9
    CrossrefPubMedGoogle Scholar
  • 32 Miller ES, Grobman WA, Culhane J. , et al. Antenatal depression, psychotropic medication use, and inflammation among pregnant women. Arch Women Ment Health 2018; 21 (06) 785-790
    CrossrefPubMedGoogle Scholar
  • 33 Mitchell J, Goodman J. Comparative effects of antidepressant medications and untreated major depression on pregnancy outcomes: a systematic review. Arch Women Ment Health 2018; 21 (05) 505-516
    CrossrefPubMedGoogle Scholar
  • 34 Eke AC, Saccone G, Berghella V. Selective serotonin reuptake inhibitor (SSRI) use during pregnancy and risk of preterm birth: a systematic review and meta-analysis. BJOG 2016; 123 (12) 1900-1907
    CrossrefPubMedGoogle Scholar