Online Program

Severe Depressive Symptoms during Pregnancy and Small-for-Gestational Age Infants: Does Confrontive Coping Style Moderate the Relationship

Tuesday, November 3, 2015

Purni Abeysekara, MPH, Community Health and Prevention, Drexel University, Philadelphia, PA
Jaime Slaughter, PhD, MPH, Department of Doctoral Nursing, College of Nursing & Health Professions, Drexel University, Philadelphia, PA
Cleopatra Caldwell, PhD, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Rhonda Dailey, MD, Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI
Carmen Giurgescu, PhD, MSN, BSN, College of Nursing, Wayne State University, Detroit, MI
Dawn Misra, PhD, Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit
Background: Ways of coping (WOC) can moderate the relationship between antenatal depression and small-for-gestational age (SGA) births. We sought to examine how the use of confrontive coping influences the relationship between severe depressive symptoms (DS) during pregnancy and the rate of SGA. Methods: Data were obtained from a cohort of 1410 Black women in Metropolitan Detroit, Michigan (71% response rate; 14.5% SGA) using maternal interviews and medical record abstraction. The Center for Epidemiologic Studies Depression Scale was used to measure severe DS (score>23). Confrontive coping was assessed using the WOC questionnaire. Analyses were stratified by confrontive coping style; modified-Poisson regression models were used to calculate unadjusted and adjusted prevalence ratios (PR) with 95% confidence interval (CI). Results: Approximately 20% of women had severe DS. Unadjusted results showed severe DS among women that used confrontive coping (PR=1.4, 95% CI: 1.0-2.0) were significantly associated with SGA prevalence. No significant differences in the SGA prevalence were found (p=0.87) among women that used non-confrontive coping. After adjusting for demographics, parity, physical health and smoking during pregnancy, women with severe DS who employed confrontive coping were 1.4 times (95% CI: 0.98-2.13, p= 0.07) as likely to have a SGA infant.  Again no significant difference in SGA prevalence were found among women that employed non-confrontive coping (p=0.63). Significance/Recommendations: Our findings suggest confrontive coping moderates the relationship between severe DS and SGA. In addition to screening for DS during pregnancy clinicians may want to assess coping styles since coping styles drive women’s appraisal and response to stress.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Demonstrate the link between severe depression during pregnancy and restricted fetal growth. Evaluate whether confrontive and non-confrontive ways of coping moderates the relationship between depressive symptoms and SGA. Analyze confrontive coping style as a risk factor for SGA.

Keyword(s): Depression, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a current third year doctoral student at Drexel University School of Public Health. I worked on this project under the mentorship of Dr. Jamie Slaughter. My research interests and past experience have focused on maternal and child health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.