Perinatal Depression and Birth Outcomes in a Healthy Start Project

Abstract

Given the risk of adverse perinatal outcomes associated with a depressive disorder, the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) from 2001–2005 devoted resources through the Federal Healthy Start Initiative to screen pregnant women for depression and link them with services. In this report, we present the evaluation of a program that screened for depression and provided services for women with depressive symptoms or psychiatric distress in pregnancy to assess whether the program was associated with a reduction in babies born low birth weight, small for gestational age, or preterm. The program impact was examined among 1,100 women in three cohorts enrolled from 2001–2005 that included: (1) subjects recruited prior to the inception of the Healthy Start Initiative; (2) subjects enrolled in the Healthy Start Initiative; and (3) a comparison group recruited during the project period but not enrolled in the Healthy Start Initiative. After adjustment for covariates, women with probable depression were over one and a half times more likely to give birth to a preterm baby than non depressed women. Neither adjusted nor unadjusted risks for delivery of preterm, low birth weight or small for gestational age infants were significantly lower for women enrolled in Healthy Start as compared to women not enrolled in Healthy Start. However, regardless of enrollment in Healthy Start, women who delivered babies after the Healthy Start program began were 85% less likely to deliver preterm babies than women giving birth before the program began. Depression status conferred increased risk of adverse birth outcomes, results that were not altered by participation in the Healthy Start program. We cannot exclude the possibility that the community activities of the Healthy Start program promoted increased attention to health issues among depressed women and hence enhance birth outcomes.

The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review

“…In four of them there was no statistical significance of the effect of DAS on PTB, as CI contained the null value. Overall, eight studies reported a significantly increased risk for PTB 8,[12][13][14][15][16][17][18] ; one study reported a positive predictive value between exposure and outcome, 19 and five studies reported no statistically significant increase in risk. 11,[20][21][22][23] Both independent and mediated (through antidepressant use) effects for depression were identified across studies.…”

Eating Disorders and Trauma History in Women with Perinatal Depression

“…childbirth outcomes, such as preterm delivery and low birth weight, 26,27 and to detrimental effects on maternal sensitivity in the postpartum period. 28,29 Specifically, mothers who are more sensitive and responsive to their children are more likely to have children with secure attachment.…”

A study of antenatal anxiety: comparison across trimesters

“…1,2 Depression and anxiety have been linked to somatic complaints, gestational and obstetric complications, stillbirth, premature birth, low birth weight, low Apgar scores, smaller head circumference, alterations in fetal motor activity, affected fetal heart rate patterns and major congenital anomalies. [3][4][5][6][7][8] Some studies found the prevalence of similar antenatal anxiety across all three trimesters, but many Previous studies reported that antenatal anxiety varied at different trimesters of pregnancy and high anxiety was found during first and third trimester.…”