Association between depressive symptoms in adolescence and birth outcomes in early adulthood using a population-based sample

Background: Adolescent depressive symptomatology is an unrecognized mood disorder that impairs health in adolescence or adulthood.   Despite this, the long term effects of depressive symptoms prior to pregnancy and the relationship to birth outcomes (low birth weight-LBW and preterm births-PTB) have not been given adequate empirical assessments. 

Method: In this study, we evaluated the relationship between the life time duration of depressive symptoms over a 14 year period and birth outcomes among a sample of 6023 female respondents who took part in the National Longitudinal Study of Adolescent Health.  We used the generalized estimating equation models to evaluate these relationships. 

Results: Exposure to elevated depressive symptoms in adolescence, but not in adulthood was associated with LBW or PTB outcome. Maternal race modified the relationship between consistent reporting of depressive symptoms in adolescence and birth outcomes such that mothers with elevated depressive symptoms in adolescence were at lower odds of LBW (OR=0.21, 95% CI: 0.07, 0.64) or PTB (OR=0.24, 95% CI: 0.06, 0.95) among black mothers in adulthood than on unexposed counterparts. Paradoxically, for both black and Hispanic mothers, consistent reporting of elevated depressive symptoms in adulthood was associated with increased odds of LBW and PTB.

Conclusion: Effects of elevated depressive symptomatology on LBW or PTB appear to be linked to specific development period in adolescence, but not in adulthood. National policies to address social inequalities particularly in health at all stages of human development will provide an important step in reducing depressive disorders prior to early adulthood and in pregnancy.