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Depression During Pregnancy Linked to Preterm Birth

A new study involving over 14,000 pregnant women adds to evidence that serious clinical depression can have an impact on pregnancy outcomes.

Researchers found that women who screened positively for depression during pregnancy were more likely than other women to give birth early: (14% vs. 10%.) The study, published this month in the American Journal of Obstetrics & Gynecology, does not prove a connection between preterm birth and depression. Researchers took into account other factors such as maternal age and race and history of preterm, but did not take into account use of drugs, alcohol and pre-pregnancy weight all of which can contribute to timing of delivery.

Lead researcher Dr. Richard K. Silver, of the NorthShore University HealthSystem and University of Chicago in Illinois says these findings– though not definitive– are consistent with other studies looking at depression and preterm birth.

Dr. Silver also commented that he’s unaware of studies showing that treatment of prenatal depression helps with pregnancy outcomes, that lots of moms don’t want to take medication during pregnancy, and that insurance often doesn’t cover mental health treatment for women. He said that we should educate women about how to recognize preterm birth in the (slim) chance that it can be postponed via medication.

That conclusion actually makes me feel a little bit clinically depressed. It’s true that being able to identify preterm birth is a fine idea. But there’s so many other things that can and need to be done.

The American College of Obstetricians and Gynecologists (ACOG) says that screening pregnant women for depression can benefit pregnant women, new mothers and their families. In fact, according to ACOG, screening should be “strongly considered” by women and their doctors.  Silver guesses that fewer than half of all pregnant women in the US are screened. (Were you screened? Let’s see a show of hands.)

The cost of clinical depression in expectant and new moms can be steep. We know that as many as 10-20% of are clinically depressed during pregnancy, whether the root of the depression stems from a history of depression, hormonal upheaval or circumstances/lack of social support.

Research also shows that 50 to 75% of pregnant women with a history of depression who discontinue antidepressants upon becoming pregnant will relapse during their pregnancy. Early intervention, including medication and talk therapy or connecting with other moms, may help prevent not just preterm birth but postpartum depression and a score of other problems for mother and baby. Here’s a compelling piece on the topic by Katherine Stone, a fiercely strong advocate for pregnant women and new mothers when it comes to mental health issues. Taking good care of your mental health is a part of all-around pregnancy wellness. I wish more support were built into the system. As it is we most often have to be pro-active about this aspect of our care… which is hard to do when you’re depressed.

 

Photo credit: Joe Penna/Flickr

 

 

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