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Longitudinal Study of Depressive Symptoms and Health-Related Quality of Life (HRQoL) in Pregnancy

Rosanna Setse, MD, MPH, Department of Epidemiology and Gynecology and Obstetrics, Johns Hopkins Schools of Medicine and Public Health, 600 N Wolfe Street, Phipps Building, Room 247, Baltimore, MD 21287, 443 287 6942, wnichol@jhmi.edu, Rosanna Setse, MD, MPH, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 600 N Wolfe Street, Phipps Building, Room 247, Baltimore, MD 21287, and Luu Pham, PhD, Biostatistics, Johns Hopkins Bloomberg School of Public Health, 600 North Wolfe Street/Phipps 247, Baltimore, MD 21287.

Objective: Depression during pregnancy can be associated with higher prenatal care utilization and lost maternal work days. We studied the independent effect of depressive symptoms on health-related quality of life (HRQoL) during pregnancy.

Methods: We conducted a longitudinal study of 102 women receiving prenatal care. The outcome was HRQoL scores from the 8 domains of the Medical Outcomes Study Short Form (SF-36). The independent variable was the presence of depressive symptomatology, defined as a Center for Epidemiologic Studies Depression (CES-D) score of ³16. Depressive symptomatology and HRQoL scores were collected during the second trimester, third trimester and within 2 days following delivery. We used logistic regression models and generalized estimating equations (GEE) to measure the independent effect of depressive symptoms on HRQoL.

Results: The study population was (58%) African-American, (30%) White and (12%)Asian. Median maternal age was 28 years (range 14-42). Prevalence of depressive symptoms was 15%. After adjustment for socio-demographics, clinical factors, and social support, depressive symptoms remained independently associated with HRQoL scores that were 40 points lower in Role-Emotional in the second trimester (Regression coefficient (RC) -40; 95% CI -70, -16); 12 points lower in Vitality in the third trimester (RC -12; 95% CI -21, -2); and 20 points lower in Mental Health (RC -20; 95% CI -28, -11) in the 2 days following delivery.

Conclusions: In this ethnically diverse sample, depressive symptoms are associated with lower HRQoL scores throughout pregnancy. These findings might inform prenatal guidelines that incorporate depression screening and targeted interventions throughout the prenatal period.

Learning Objectives:

Keywords: Depression, Pregnancy

Presenting author's disclosure statement:

Any relevant financial relationships? No

Quality of Life for Women: Responses to Lifecourse Events and Disasters

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA