No Association between Antenatal Common Mental Disorders in Low-Obstetric Risk Women and Adverse Birth Outcomes in Their Offspring: Results from the CDS Study in Ghana and Côte D'Ivoire

Abstract

BackgroundEvidence linking common mental disorders (CMD) in pregnant women to adverse birth outcomes is inconsistent, and studies often failed to control for pregnancy complications. This study aimed to explore the association between antenatal depression and anxiety symptoms and birth outcomes in a low-obstetric risk sample of mother/child dyads in Ghana and Côte d’Ivoire.MethodsIn 2010-2011, a prospective cohort of 1030 women in their third trimester in Ghana and Côte d’Ivoire was enrolled. Depression and anxiety were assessed in the third trimester using the Patient Health Questionnaire depression module and the 7-item Generalized Anxiety Disorder scale. 719 mother/child dyads were included in the analysis. We constructed multivariate regression models to estimate the association between CMD and low birth weight (LBW), and preterm birth (PTB) to control for potential confounders.ResultsThe prevalence of depression and anxiety symptoms were 28.9% and 14.2% respectively. The mean birth weight was 3172.1g (SD 440.6) and the prevalence of LBW was 1.7%. The mean gestational age was 39.6 weeks and the proportion of PTB was 4%. Multivariate linear regression revealed no significant association between maternal depression (B=52.2, 95% CI -18.2 122.6, p=0.15) or anxiety (B=17.1, 95% CI -74.6 108.7, p=0.72) and birth weight. Yet, low socio-economic status, female sex of the child, and younger maternal age were associated with lower birth weight. Multivariate logistic regression suggested no significant association between maternal depression (OR: 2.1, 95% CI 0.8 5.6, p=0.15) or anxiety (OR: 1.8, 95% CI 0.6 5.5, p=0.29) with PTB.ConclusionsOur data suggests that depression and/or anxiety in the 3rd trimester of pregnancy are not independent predictors of adverse birth outcomes in low obstetric risk women. The role of pregnancy complications as confounders or effect modifiers in studies of maternal CMD and their impact on birth outcomes should be investigated.

Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis

“…Third trimester Aaron et al (2015) 46 Bjork et al (2015) 47 Cheng et al (2015) 48 Dubber et al (2015) 49 Ibanex et al (2015) 50 Pazzagl et al (2015) 51 Pisoni et al (2016) 52 Vilela et al (2015) 37 Broekman et al (2014) 13 Ferreira et al (2014) 53 Garthus-Niegel et al (2014) 3 Huizink et al (2014) 29 Meijer et al (2014) 30 Jokic-Bergic et al (2014) 54 Tan et al (2014) 55 Verreault et al (2014) 56 Bindt et al (2013) 57 George et al (2013) 7 Makara-Studzinska et al (2013) 31 Roos et al (2013) 40 Figueiredo & Conde (2011) 32 Mohammad et al (2011) 58 Hall et al (2009) 5 DiPietro et al (2008) 59 Keeton et al (2008) 60 Lee et al (2007) 34 Shi et al (2007) 43 Bene et al (2005) 12 Heron et al (2004) 44 Rondo et al (2003) 35 Ross et al (2003) 61 Teixeira et al (1999) 62 Crandon et al (1979) 63 Subtotal (I 2 = 99%, P = 0.000) 2 and online Fig. DS1).…”

Factors associated with the probability of common mental disorders in pregnant women: a cross-sectional study

“…The same study revealed that pregnant women described episodes of bleeding during the 1 st and 2 nd trimesters of pregnancy, which were associated with signs and symptoms that indicated depression and anxiety. 8 Results from a study performed with pregnant adolescents showed an association between depression and episodes of bleeding. Adolescents who had this complication were 6.7 times more likely to have depression, 17 evidence that corroborates the results expected for this study.…”

“…3,6,7 The following factors are also associated: living without a partner, planned pregnancy, gestational age and gestational complications. 3,5,6,8 Thus, the present study is justified when the probability of CMD in this special time women experience and the variables that increase its chances during pregnancy are taken into consideration.…”

Relationship Between Common Mental Disorder Symptoms During Pregnancy and Preterm Birth Among Chinese Women in Wuhan

“…During the same time period, an equal number of controls were randomly selected from all women with births of at least 37 completed weeks of gestation and birth weight of at least 2500 g from the same regions as the cases. The cases and controls were required to meet the following criteria: (1) the mothers were to have lived in one of the seven innercity districts of Wuhan for at least 2 years, (2) to have given birth in a hospital located in the inner-city and rested in the inner city following delivery, (3) to not have a history of mental disorder prior to pregnancy, (4) and to deliver an infant with a gestational age between 20 and 46 weeks, (5) and a birth weight between 500 and 5000 g, and (6) to have a singleton live birth without any birth defects. 4308 cases and 4308 controls were included in this study.…”

“…Because of differences in study populations, socioeconomic background, and maternal health profile, evidence on the effect of CMDP on PTB is somewhat conflicting. A recent meta-analysis suggested that CMDP were associated with an increased risk of PTB [13], but individual studies done in low-obstetric risk women failed to observe such an association [3]. These results demonstrated the importance of studying the cultural context related to the association between mental health and birth outcomes.…”