Small-for-Gestational-Age Births are Associated with Maternal Relationship Status: A Population-Wide Analysis

Symptoms of Depression and Preterm Birth Among Black Women

OBJECTIVE

To investigate the relationship between depressive symptoms and preterm birth (PTB) while adjusting for social support, both general and from the father of the baby.

DESIGN

Retrospective study design.

SETTING

Participants of the Life-course Influences of Fetal Environments (LIFE) study were recruited from a suburban hospital in Metropolitan Detroit, Michigan.

PARTICIPANTS

The LIFE data consisted of 1,410 self-identified Black women age 18 to 45 years; 1,207 women were included in this analysis.

METHODS

Women were interviewed using a structured questionnaire administered 24 to 48 hours after birth during their postpartum hospitalization. Data on the newborns and their mothers' health were collected through medical record abstraction. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure symptoms of depression. The CES-D scores ≥23 were considered severe symptoms of depression. Modified Poisson regression models were built using a stepwise approach to assess association between symptoms of depression and PTB.

RESULTS

Approximately, 17% of women had a PTB and 20% of women in the sample had a CES-D scores ≥23. Women who had CES-D score ≥23 were about 70% more likely to have a PTB compared with women with CES-D scores <23 (PR = 1.68, 95% CI: 1.24-2.16) after adjustment for both general social support and father of the baby support.

CONCLUSION

Women with CES-D scores ≥23 were almost twice more likely to have PTB compared with women with CES-D scores <23. Referrals for mental healthcare providers might benefit women with symptoms of depression and improve birth outcomes. Nurses should encourage women to seek support beyond the father of the baby.

Mentors Offering Maternal Support Reduces Prenatal, Pregnancy-Specific Anxiety in a Sample of Military Women

OBJECTIVE

To determine the efficacy of the Mentors Offering Maternal Support (MOMS) program to reduce pregnancy-specific anxiety and depression and build self-esteem and resilience in military women.

DESIGN

Randomized controlled trial with repeated measures.

SETTING

Large military community in Texas.

PARTICIPANTS

Pregnant women (N = 246) in a military sample defined as active duty or spouse of military personnel.

METHODS

Participants were randomized in the first trimester to the MOMS program or normal prenatal care. Participants attended eight 1-hour sessions every other week during the first, second, and third trimesters of pregnancy. Pregnancy-specific anxiety, depression, self-esteem, and resilience were measured in each trimester. Linear mixed models were used to compare the two-group difference in slope for prenatal anxiety, depression, self-esteem, and resilience.

RESULTS

The Prenatal Self-Evaluation Questionnaire was used to measure perinatal anxiety. Rates of prenatal anxiety on the Identification With a Motherhood Role (p = .049) scale and the Preparation for Labor (p = .017) scale were significantly reduced for participants in MOMS. Nulliparous participants showed significantly lower anxiety on the Acceptance of Pregnancy scale and significantly greater anxiety on the Preparation for Labor scale. Single participants had significantly greater anxiety on the Well-Being of Self and Baby in Labor scale, and participants with deployed husbands had significantly greater anxiety on the Identification With a Motherhood Role scale.

CONCLUSION

Participation in the MOMS program reduced pregnancy-specific prenatal anxiety for the dimensions of Identification With a Motherhood Role and Preparation for Labor. Both dimensions of anxiety were previously found to be significantly associated with preterm birth and low birth weight. Military leaders have recognized the urgent need to support military families.