Depression in pregnancy tied to preterm delivery

Women who have depression symptoms during pregnancy may be more likely to deliver early, a new report suggests.

In a study of more than 14 000 pregnant women, 14% of those who screened positive for possible clinical depression delivered before the 37th week of pregnancy, versus 10% of other women. The findings, reported in the American Journal of Obstetrics & Gynecology, do not prove that depression directly leads to preterm birth.

What the study found

The researchers were able to account for some other factors - like a mother's race and age - and depression was still linked to preterm birth risk. But there are other variables the study could not weigh, including smoking and drinking habits during pregnancy, and pre-pregnancy weight. So there could be other explanations.

Still, the findings align with past studies that have found a link between prenatal depression and preterm birth, said senior researcher Dr Richard K. Silver, of the NorthShore University HealthSystem and University of Chicago in Illinois. And with depression being a form of serious stress for moms, a link to preterm birth is also "biologically plausible," Dr Silver told Reuters Health.

Some studies have found that women who use antidepressants during pregnancy have a higher risk of preterm birth - though that does not prove the medications are to blame. Dr Silver said he thinks it's more likely that medication use is serving as a proxy for potential effects of depression itself.

Depression treatment determines outcomes

He also said he's not aware of research suggesting that depression treatment improves women's pregnancy outcomes. "That's to be determined," he said.

It's a tricky thing to study, he noted, since researchers cannot ethically conduct a clinical trial where they withhold treatment from some depressed pregnant women while treating others. Dr Silver said pregnant women with depression should be educated on the potential warning signs of preterm labour.

As for depression treatment, many women do not want to take medication of any kind during pregnancy, Dr Silver noted. All of the women in the current study were screened for depression as part of a universal screening program. According to the American College of Obstetricians and Gynecologists, depression screening can benefit pregnant women, new moms and their families, and should be "strongly considered" by women and their doctors.

But in practise, doctors vary in whether they screen. Dr Silver said his guess is that fewer than half of pregnant women in the US are screened for depression.

(Reuters Health, Amy Norton, July 2012)

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