Prenatal maternal depression is associated with low birth weight through shorter gestational age in term infants in Korea

Antenatal depression among pregnant women in Ethiopia: An umbrella review

INTRODUCTION

Antenatal depression, ranging from mild to severe, is influenced by hormonal changes during pregnancy and childbearing years, making it a significant public health issue. Antenatal depression, with its far-reaching effects on mothers, infants, and children, continues to be a significant public health issue in developing countries such as Ethiopia. Research on antenatal depression in Ethiopia has produced varied results. Although previous systematic reviews and meta-analyses studies have addressed this topic, a comprehensive summary of existing reviews has not been available. Therefore, this umbrella review aims to consolidate the findings on antenatal depression and associated factors among pregnant women in Ethiopia.

METHODS

This review included five systematic reviews and meta-analyses from various databases, including PubMed, PsycINFO, Research4life, CINHALE and Science Direct. Only reviews published between January 1, 2010, and July 30, 2024, were considered. The search, conducted from August 5 to 15, 2024, used CoCoPop questions and included only English-language reviews. Study quality was assessed with the AMSTAR tool, and data extraction and analysis were performed using Microsoft Excel 2016 and STATA 14.0. The I2 and Cochran's Q tests were used to assess heterogeneity. Pooled effect sizes were calculated based on the pooled prevalence of antenatal depression and odds ratios for associated factors, with a 95% confidence interval indicating statistical significance.

RESULTS

This umbrella review encompassed 50 primary studies from five systematic reviews and meta-analyses, involving a total of 25,233 pregnant women. The pooled prevalence of antenatal depression in Ethiopia was found to be 24.60% (95% CI: 22.46-26.73). Significant associations were identified between antenatal depression and several factors: unplanned pregnancy (POR = 2.29; 95% CI: 1.75, 2.82), poor social support (POR = 2.10; 95% CI: 1.37, 2.84), history of abortion (POR = 2.49; 95% CI: 1.64, 3.34), history of depression (POR = 3.57; 95% CI: 2.43, 4.71), and history of obstetric complications (POR = 2.94; 95% CI: 1.61, 4.28).

CONCLUSIONS

The significant prevalence of antenatal depression (24.60%) among pregnant women in Ethiopia is closely linked to factors such as unplanned pregnancy, poor social support, history of abortion, previous depression, and obstetric complications. To tackle this issue, it is recommended to enhance social support networks, increase access to family planning services to minimize unplanned pregnancies, conduct regular mental health screenings, and incorporate mental health services into antenatal care.

Giving Birth in Unpredictable Conditions: Association between Parents' COVID-19 Related Concerns, Family Functioning, Dyadic Coping, Perceived Social Support and Depressive Symptoms

BACKGROUND

The way postpartum parents' COVID-19-related concerns are associated with the family environment, support resources and depressive symptoms areunder-investigated.

METHODS

Two hundred and forty-three new parents (132 mothers, 111 fathers) completed self-report questionnaires within an 8-week period after birth. Parental concerns for COVID-19-related life changes were assessed with the COVID-19 Questionnaire, perceived social support with the Multidimensional Scale of Perceived Social Support, perceived family functioning with the Family Adaptability and Cohesion Evaluation Scales IV Package, dyadic coping behaviors with the Dyadic Coping Inventory and maternal/paternal postnatal depression with the Edinburgh Postnatal Depression Scale.

RESULTS

(a) Higher levels of COVID-19-related concerns about daily life were associated with lower levels of family communication, satisfaction and increased depressive symptomatology in both parents, and with lower levels of family functioning in mothers; (b) Maternal health care COVID-19-related concerns were linked with lower levels of family communication, lower perceived social support and with an increase in maternal depressive symptoms; and (c) COVID-19-related concerns about neonate hospitalization were associated with increased maternal depressive symptoms.

CONCLUSION

Τhese findings suggest that COVID-19-related concerns had a common negative effect on both postpartum mothers' and fathers' mental health and on certain aspects of family functioning.

Examining maternal depression, birthweight and linear growth: Findings from the South African National Income Dynamics Study

Background. Literature is inconclusive regarding an association between maternal depression, low birthweight (LBW) and stunting in early childhood. While some studies have found an association, others have not. Maternal food insecurity is a risk factor for both maternal depression and reduced linear growth in early childhood.  Objective. This study examined the relationship between maternal depression, food insecurity, LBW and stunting in the first five years of life. The study employed longitudinal data of South African women and children from the National Income Dynamics Study (NIDS).  Methods. Mothers were classified into four groups: food insecure and depressed; food insecure only; depressed only; and neither food insecure nor depressed. During data collection, 22% of women were pregnant and the remaining 78% were pre-conception. The primary outcomes were low birthweight and height-for-age (HAZ) scores. Generalised Linear Mixed Effects (GLME) models were used to account for women having more than one child. GLME models with a Gaussian link function were used to compare mean differences in birthweight and HAZ scores. Multivariable regression models were used to examine factors associated with depression.  Results. Food insecurity was significantly associated with depression among pre-conceptional and pregnant women. There was no statistically significant difference in birthweight or linear growth across groups, but this may be influenced by proximity of depression measurement in relation to outcomes.  Conclusion. Food insecurity is a potentially modifiable risk factor for depression and may be a confounding factor in studies that have found associations between depression and child health outcomes. 

Antenatal Depression as a Stunting Risk Factor: A Systematic Review

BACKGROUND: Depression during pregnancy is often found and ignored even though depression has a negative impact not only on the mother but also on the fetus to adulthood. Stunting is a problem of lack of nutritional status that begins during pregnancy. AIM: The purpose of this article is to systematically identify the description and relationship between depression during pregnancy and stunting in children. METHOD: The approach used is the systematic review method to search articles. Articles were identified from 2010-2020 by conducting a literature search with the keywords "antenatal depression" OR "prenatal depression" OR "depression during pregnancy" and "stunting" in the electronic databases dataset by Sciencedirect, Pubmed Research Gate, and Google Scholar. RESULTS: The search results found 1875 articles selected into 20 journal articles that match the inclusion criteria. CONCLUSION: The results found that depression during pregnancy correlated with risk factors for stunting. As a preventive measure, health workers, especially midwives, can provide psychological care in antenatal care by considering these factors.

Effect of perinatal depression on birth and infant health outcomes: a systematic review and meta-analysis of observational studies from Africa

Background

Antenatal depression is associated with intrauterine growth retardation, preterm birth, and low birth weight. Infants born to mothers with postnatal depression also may suffer from malnutrition and other health problems. Even though there are few single studies conducted so far, a systematic review of these studies is highly important to highlight the effect of antenatal and perinatal depression on adverse birth and infant health outcomes in Africa.

Methods

We used the Preferred Report Items for Systematic Review and Meta-analysis (PRISMA) when conducting this study. Databases like CINAHL (EBSCO), MEDLINE (via Ovid and PubMed), PsycINFO, Emcare, Psychiatry Online, and Scopus were searched. In addition, Google Scholar and references from a list of eligible studies were explored. We included good quality observational studies based on Newcastle Ottawa Scale which are published in the English language between 2007 and 2018.  Heterogeneity and publication bias were assessed. Meta-analysis with a random effect model was employed to determine the pooled effect sizes with a 95% confidence interval. The review protocol is registered in PROSPERO (CRD42018106714).

Result

We found three studies (1511 participants) and 11 studies (22,254 participants) conducted on the effect of antenatal depression on birth outcomes and perinatal depression on adverse infant health outcomes, respectively. The overall risk of having adverse birth outcomes was 2.26 (95% CI: 1.43, 3.58) times higher among pregnant mothers with depression. The risk of preterm birth and low birth weight was 1.77 (95% CI: 1.03, 3.04) and 2.98 (95% CI: 1.60, 5.55) respectively. Similarly, the risk of having adverse infant health outcomes namely malnutrition and febrile illness was 1.61 (95% CI: 1.34, 1.95) times higher among mothers who had perinatal depression.

Conclusions

We have found a significant association between antenatal depression and adverse birth outcomes, low birth weight and preterm birth. Similarly, a significant effect of perinatal depression on adverse infant health outcomes namely, malnutrition, and febrile illnesses was observed. The findings highlight that it is time to integrate mental health services with routine maternal health care services to improve birth outcomes and reduce infant morbidity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00792-8.

Neglecting Maternal Depression Compromises Child Health and Development Outcomes, and Violates Children's Rights in South Africa

The intention of the South African Children’s Act 38 of 2005 is to provide guarantees for the protection and promotion of optimum health and social outcomes for all children. These guarantees are the provision of basic nutrition, basic health care and social services, optimal family or parental care, as well as protection from maltreatment, neglect and abuse services. However, despite these guarantees, child and maternal mortality remain high in South Africa. The literature identifies maternal depression as a common factor that contributes to negative health and social outcomes for both mothers and their children. Despite the availability of easy-to-use tools, routine screening for maternal depression is not carried out in public health services, which is the source of services for the majority of women in South Africa. The results are that the mothers miss out on being diagnosed and treated for maternal depression, which results in negative child outcomes, such as malnutrition, as well as impacts on mental, social and physical health, and even death. The long-term impacts of untreated maternal depression include compromised child cognitive development, language acquisition and deviant behaviors and economic disadvantage in later life. The author concludes that the neglect of screening for, and treatment of maternal depression therefore violates the constitutional rights of the affected children, and goes against the spirit of the Constitution. The author recommends that maternal and child health services integrate routine screening for maternal depression, which will not only satisfy the Constitutional mandate, but also improve the health and developmental outcomes of the children and reduce child mortality.

Maternal caregiving capabilities are associated with child linear growth in rural Zimbabwe

Between birth and 2 years, children's well-being depends on the quality of care they receive from caregivers, primarily their mothers. We developed a quantitative survey instrument to assess seven psychosocial characteristics of women that determine their caregiving ability ('maternal capabilities': physical health, mental health, decision-making autonomy, social support, mothering self-efficacy, workload and time stress, and gender norm attitudes). We measured maternal capabilities in 4,025 mothers and growth in their 4,073 children participating in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe. We used generalized estimating equation models with exchangeable correlation structure to test the association between each maternal capability during pregnancy, and infant length-for-age Z (LAZ) at 18 months, accounting only for within-cluster correlation and intervention arms in unadjusted analyses and for potential confounders in adjusted analyses to examine the association between each capability, assessed during pregnancy, with child LAZ at 18 months of age. In adjusted models, each unit increase in gender norm attitudes score (reflecting more equitable gender norm attitudes) was associated with +0.09 LAZ (95% CI: 0.02, 0.16) and a decreased odds of stunting (adjusted odds ratio [AOR]: 0.86; 95% CI: 0.74, 1.01); each unit increase in social support score was associated with +0.11 LAZ (95% CI: 0.05, 0.17, p < 0.010) and decreased odds of stunting (AOR: 0.83; 95% CI: 0.73, 0.96). Each unit increase in decision-making autonomy was associated with a 6% reduced odds of stunting (AOR: 0.94; 95% CI: 0.89, 0.996, p = 0.04). Interventions and social programming that strengthen these maternal capabilities may improve child nutritional status.

Three machine learning algorithms and their utility in exploring risk factors associated with primary cesarean section in low-risk women: A methods paper

Machine learning, a branch of artificial intelligence, is increasingly used in health research, including nursing and maternal outcomes research. Machine learning algorithms are complex and involve statistics and terminology that are not common in health research. The purpose of this methods paper is to describe three machine learning algorithms in detail and provide an example of their use in maternal outcomes research. The three algorithms, classification and regression trees, least absolute shrinkage and selection operator, and random forest, may be used to understand risk groups, select variables for a model, and rank variables' contribution to an outcome, respectively. While machine learning has plenty to contribute to health research, it also has some drawbacks, and these are discussed as well. To provide an example of the different algorithms' function, they were used on a completed cross-sectional study examining the association of oxytocin total dose exposure with primary cesarean section. The results of the algorithms are compared to what was done or found using more traditional methods.

Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

Background

Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression.

Methods

We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method.

Results

The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses.

Conclusions

From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03600-3.

Depression during pregnancy and the risk of low birth weight, preterm birth and intrauterine growth restriction- an updated meta-analysis

AIM

Depression during pregnancy is a significant cause of adverse birth outcomes, and its prevalence has increased in recent years. This study aimed to give an updated quantification of the risk of preterm birth (PTB), low birth weight (LBW) and intrauterine growth restriction (IUGR) that is associated with antenatal depression.

METHOD

The search was done in different databases, including Web of Science, Scopus and PubMed, from January 2010 to March 2020, and only English-language articles were considered. We only included studies that assessed depression during pregnancy and those that reported data on antenatal depression with at least one adverse birth outcome (PTB, LBW, or IUGR). The quality of studies was assessed using an adaptation of the Newcastle-Ottawa scale assessment tool. The analysis was conducted using STATA (version 12), pooled effect sizes were calculated using the random-effects model and heterogeneity was tested for using the I² statistic.

RESULTS

The analysis included 23 studies of PTB, LBW and IUGR. There was a significant risk of PTB (RR = 1.35, 95% CI 1.19-1.52), LBW (RR = 1.86, 95% CI 1.32-2.62) and IUGR (RR = 4.39, 95% CI 2.45-7.86). Control for confounders, time of assessing depression, among others altered the risk of LBW due to depression. In addition, depressed women in developing countries had a higher risk of PTB (RR = 2.07, 95% CI 1.13-3.81).

CONCLUSION

This study identifies a significant risk of PTB, LBW and IUGR due to antennal depression and recognises a need for targeted preventive interventions such as prompt screening to improve and promote maternal mental health care.

The importance of depression during pregnancy

OBJECTIVE

Today, the high prevalence of depression is one of the major health problems of pregnant women. This study aimed to assess the relationship between antenatal depression, pregnancy and neonatal outcomes.

METHODS

This cohort study involved 394 pregnant women referred to the prenatal care clinic at the Al- Zahra Hospital, affiliated to Guilan University of Medical Sciences, Iran. We used a convenient method for sampling. We collected data using questionnaires on demographic and obstetric characteristics, the CES-D scale for depression evaluation and a checklist for recording pregnancy outcomes.

RESULTS

According to the results, preeclampsia, premature membrane rupture, preterm delivery, cesarean section, intrauterine fetal death, and intrauterine fetal growth restriction were higher among mothers with depression during their pregnancies, compared to those who did not have depression. In addition, the mean birth weights of depressed mothers' infants were lower than the infants of mothers who did not have depression.

CONCLUSION

Results from the present study showed that depression during pregnancy is associated with pregnancy and neonatal outcomes. Healthcare planners and mental health counselors should regard screening mothers with risk of depression and following them up and, in the necessary cases, referring to psychiatrists.

Pre-existingmental health disorders affect pregnancy and neonatal outcomes: a retrospectivecohort study

BACKGROUND

This was a hospital registry-based retrospective age-matched cohort study that aimed to compare pregnancy and neonatal outcomes of women with pre-existing mental disorders with those of mentally healthy women.

METHODS

A matched cohort retrospective study was carried out in the Department of Obstetrics and Gynecology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, a tertiary health care institution. Medical records of pregnant women who gave birth from 2006 to 2015 were used. The study group was comprised of 131 pregnant women with mental disorders matched to 228 mentally healthy controls. The primary outcomes assessed were antenatal care characteristics; secondary outcomes were neonatal complications.

RESULTS

Pregnant women with pre-existing mental health disorders were significantly more likely to have low education, be unmarried and unemployed, have a disability that led to lower working capacity, smoke more frequently, have chronic concomitant diseases, attend fewer antenatal visits, gain less weight, be hospitalized during pregnancy, spend more time in hospital during the postpartum period, and were less likely to breastfeed their newborns. The newborns of women with pre-existing mental disorders were small for gestational age (SGA) more often than those of healthy controls (12.9% vs. 7.6%, p < 0.05). No difference was found comparing the methods of delivery.

CONCLUSIONS

Women with pre-existing mental health disorders had a worse course of pregnancy. Mental illness increased the risk to deliver a SGA newborn (RR 2.055, 95% CI 1.081-3.908).

The Association Between Demographic Characteristics and Attempting of Pregnancy with Postpartum Depression and Anxiety Among Women Referring to Community Health Centres: A Cross Sectional Study

Background

Postpartum depression (PPD) and anxiety are considered as a risk factor for mother and infant health. Therefore, the present study aims to explore the association between demographic characteristics and pregnancies with PPD and anxiety.

Methods

A cross-sectional study was conducted on 400 Iranian women referring to health centres of the Zarand City four weeks to six months from the date of their childbirth, in the first half of 2018.

Result

The results showed that employed women with pregnancies who were categorised as depression and anxiety were more likely to have low gestational age, food insecurity, several deliveries, cesarean delivery and unintended pregnancy as well as they were not satisfied with their infant’s gender. Also, women with several deliveries had lower risk for PPD before and after adjustment for confounders (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.88–0.97, P < 0.001) and had lower risk for postpartum anxiety only after adjustment for confounders (OR = 0.82, 95% CI: 0.75–0.89, P < 0.001).

Conclusion

Eventually, demographic characteristics and attempting of pregnancy were independently associated with PPD and postpartum anxiety in women. There need to be more social and governmental support of employed women after delivery to decrease their occupational stresses to deal with PPD and anxiety in the studied population.

Evaluation of Telepsychiatry-Enabled Perinatal Integrated Care

OBJECTIVE

The purpose of this article is to describe the implementation of the first known telepsychiatry-enabled model of perinatal integrated care and to report initial results following implementation.

METHODS

Behavioral health screening data were collected from 712 patients at an urban women's clinic, and a more in-depth set of process and outcome measures, including treatment engagement, services utilized, and delivery and postpartum patient outcomes, was collected from 135 patients referred for behavioral health services. Using nationally published metrics to provide context, the authors applied a descriptive design to evaluate and conduct analyses of program outcomes.

RESULTS

The telehealth-enabled integrated care model was successfully implemented within a specialty obstetrics practice. Identification and treatment of behavioral health issues exceeded nationally published rates. The model was also associated with positive indices related to birth weight and breastfeeding behavior.

CONCLUSIONS

These initial results point to telepsychiatry as an effective tool for expanding perinatal integrated care and lay the foundation for further study and model refinement. The results also add to the growing body of evidence for the use of telepsychiatry-supported integrated care across diverse clinical settings and patient populations.

Epidemiology of antenatal depression in Africa: a systematic review and meta-analysis

BACKGROUND

Antenatal depression is a serious problem worldwide that has devastating consequences not only for the mother but also for the child and family. The pooled evidence regarding the prevalence and associated factors of antenatal depression is rare in Africa. Hence this review aimed to investigate the prevalence and associated factors of antenatal depression in Africa.

METHODS

We searched CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases for English written observational studies conducted in Africa from 2007 to 2018.Quality of studies was assessed using the Newcastle Ottawa Scale (NOS), and studies with good quality were included in the final review. Heterogeneity across studies was assessed using the I² and Higgins test. Publication bias was checked using Funnel plot symmetry, and Egger's regression test and adjustment was made by using Duval and Tweedie's Trim and Fill analysis. A random effect Meta-analysis was employed to determine the pooled estimates with 95% confidence interval (CI). Stata 14 was used for analysis. The review protocol has been registered in PROSPERO number CRD42018106717.

RESULT

Of the 175 studies identified, 28 studies with an overall sample size of 17,938 were included. According to the random effect model following trim and fill analysis, the pooled prevalence of antenatal depression in Africa was 26.3% (95%CI: 22.2, 30.4%). Economic difficulties [POR = 1.87;95%CI:1.25,2.78,I² = 88.1%], unfavorable marital condition [POR = 4.17;95% CI:1.75, 9.94, I² = 81.2%], poor support from relatives [POR = 1.36;95% CI:1.18, 1.56, I² = 78.0%], bad obstetric history [POR = 2.30;95% CI:1.81, 2.92), I² = 81.7%], and history of mental health problem [POR = 2.97; 95% CI:1.74, 5.06, I² = 92.0%]were the factors associated with antenatal depression.

CONCLUSION

The prevalence of antenatal depression is high in Africa, which showed that one in four pregnant women had depression. Pregnant mothers who had economic difficulties, bad obstetric history, poor support from relatives, previous mental health problems, and unfavorable marital conditions were at higher risk of antenatal depression. Therefore these factors should be considered while designing mental health care services for pregnant mothers.

Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis

Background

Depression in pregnancy (antenatal depression) in many low and middle-income countries is not well documented and has not been given priority for intervention due to competing urgencies and the belief that it does not immediately cause fatalities, which mainly emanated from lack of comprehensive research on the area. To fill this research gap, this systematic review was conducted to investigate the burden of antenatal depression and its consequences on birth outcomes in low- and middle-income countries.

Methods

We systematically searched the databases: CINHAL, MEDLINE, EMCare, PubMed, PSyc Info, Psychiatry online, and Scopus for studies conducted in low and middle-income countries about antenatal depression and its association with adverse birth outcomes. We have included observational studies (case control, cross-sectional and cohort studies), written in English-language, scored in the range of “good quality” on the Newcastle Ottawa Scale (NOS), and were published between January 1, 2007 and December 31, 2017. Studies were excluded if a standardized approach was not used to measure main outcomes, they were conducted on restricted (high risk) populations, or had fair to poor quality score on NOS. We used Higgins and Egger’s to test for heterogeneity and publication bias. Primary estimates were pooled using a random effect meta-analysis. The study protocol was registered in PROSPERO with protocol number CRD42017082624.

Result

We included 64 studies (with 44, 035 women) on antenatal depression and nine studies (with 5,540 women) on adverse birth outcomes. Antenatal depression was higher in the lower-income countries (Pooled Prevalence (PP) = 34.0%; 95%CI: 33.1%-34.9%) compared to the middle-income countries (PP = 22.7%, 95%CI: 20.1%-25.2%) and increased over the three trimesters. Pregnant women with a history of economic difficulties, poor marital relationships, common mental disorders, poor social support, bad obstetric history, and exposure to violence were more likely to report antenatal depression. The risk of having preterm birth (2.41; 1.47–3.56) and low birth weight (1.66; 1.06–2.61) was higher in depressed mothers compared to mothers without depression.

Conclusions

Antenatal depression was higher in low-income countries than in middle-income countries and was found to be a risk factor for low birth weight and preterm births. The economic, maternal, and psychosocial risk factors were responsible for the occurrence of antenatal depression. While there could be competing priority agenda to juggle for health policymakers in low-income countries, interventions for antenatal depression should be reprioritized as vitally important in order to prevent the poor maternal and perinatal outcomes identified in this review.

Anxiety, depression, and birth outcomes in a cohort of unmedicated women

BACKGROUND

Even though most of the systematic reviews suggest that depression and anxiety are related to poor neonatal outcomes, it is not yet clear whether a dose-response effect exists.

AIM

The aim of the present study is to evaluate the amount of depressive and anxiety symptoms in a cohort of pregnant women and its effect on their newborns.

METHODS

Two hundred ninety-nine women were assessed for anxiety and depressive disorders and anxious and depressive symptoms at near monthly intervals throughout pregnancy. At the time of delivery, we collected the newborns' gestational age, birth weight and the Apgar score at 1 and 5 min.

RESULTS

Sixty-seven women were diagnosed as depressed and 43 had an anxious disorder. After controlling for confounding variables only the overall levels of anxiety during pregnancy were negatively associated with birth weight (B = -5.76; 95% CI = -10.96, -2.81), suggesting the existence of a "dose-response" effect. The birth outcomes in mildly depressed pregnant women were similar to those of nondepressed women.

CONCLUSION

Anxiety symptoms, beyond a categorical diagnosis, are associated with low birth weight and should be recognized and properly treated during pregnancy.

Epigenetically regulated imprinted gene expression associated with IVF and infertility: possible influence of prenatal stress and depression

PURPOSE

Despite the growing body of research implying an impact of in vitro fertilization (IVF) on imprinted genes and epigenetics, few studies have examined the effects of underlying subfertility or prenatal stress on epigenetics, particularly in terms of their role in determining infant birthweights. Both subfertility and prenatal stressors have been found to impact epigenetics and may be confounding the effect of IVF on epigenetics and imprinted genes. Like IVF, both of these exposures-infertility and prenatal stressors-have been associated with lower infant birthweights. The placenta, and specifically epigenetically regulated placental imprinted genes, provides an ideal but understudied mechanism for evaluating the relationship between underlying genetics, environmental exposures, and birthweight.

METHODS AND RESULTS

In this review, we discuss the impacts of IVF and infertility on birthweight, epigenetic mechanisms and genomic imprinting, and the role of these mechanisms in the IVF population and discuss the role and importance of the placenta in infant development. We then highlight recent work on the relationships between infertility, IVF, and prenatal stressors in terms of placental imprinting.

CONCLUSIONS

In combination, the studies discussed, as well as two recent projects of our own on placental imprinted gene expression, suggest that lower birthweights in IVF infants are secondary to a combination of exposures including the infertility and prenatal stress that couples undergoing IVF are experiencing. The work highlighted herein emphasizes the need for appropriate control populations that take infertility into account and also for consideration of prenatal psychosocial stressors as confounders and causes of variation in IVF infant outcomes.

Antenatal depression and offspring health outcomes

Background

Depression is the most common mental disorder during pregnancy, with prevalence rates between 4% and 20%. The objective of this review was to synthesize the literature on the association between antenatal depression and offspring birth outcomes, as well as developmental, behavioral, and psychiatric outcomes.

Methods

A search of PubMed, Cochrane, and Medline databases was conducted for articles published until December 2017. Articles focusing on the effects of antenatal depression on the offspring were selected to be reviewed. Reference lists of all studies were examined for any missed articles. A total of 32 articles were included in this review.

Results

Antenatal depression is associated with preterm birth, excessive infant crying, and offspring mental health problems. Untreated antenatal depression is strongly associated with adverse effects on the infant nervous system.

Conclusion

Antenatal depression increases the likelihood of poor offspring health outcomes. Research should investigate whether medication use confounds this relationship.

Prenatal and postnatal maternal depression and infant hospitalization and mortality in the first year of life: A systematic review and meta-analysis

BACKGROUND

Prenatal and postnatal depression have been well studied in recent decades, but few studies address their relationship with hospitalization and mortality in one-year-old children.

OBJECTIVE

Review the literature about the effects of maternal depression on hospitalization and mortality of the child from birth to one year of age and conduct a meta-analysis.

METHODS

A systematic search was performed in the PubMed and LILACS databases. We included original studies that evaluated the effect of prenatal and/or postnatal depressive symptoms on child hospitalization or mortality up to one year of age. Meta-analyses were conducted according to the outcome and stratified by prenatal and postnatal depression, using random effects models.

RESULTS

Six studies were included in this review (170,371). Children of mothers with prenatal and postnatal depressive symptoms or depression had 1.44 (CI_95% 1.10 - 1.89) greater risk of hospitalization, and children of mothers with postnatal depressive symptoms or depression had 1.93 (CI_95% 1.02-3.64) greater risk of death before one year of age than those whose mothers did not have the disorder.

LIMITATIONS

Small number of studies (n < 10), different instrument and cut points were used to evaluate maternal depressive symptoms or diagnose depression.

CONCLUSION

Maternal depressive symptoms or depression have an unfavorable effect on hospitalization and mortality in children up to one year of age. This finding is relevant to public health and should stimulate the systematic screening of prenatal and postnatal depressive symptoms, so that adequate care can be provided for women and their children.

Low birth weight of institutional births in Cambodia: Analysis of the Demographic and Health Surveys 2010-2014

BACKGROUND

Low birth weight (LBW), an important risk factor for early childhood mortality and morbidity, is a major public health concern in developing countries including Cambodia. This study examined the prevalence of LBW across provinces in Cambodia and changes over time, and identified the factors associated with such condition.

METHODS

We used children datasets from Cambodia Demographic and Health Survey (CDHS) 2010 and 2014. There were 3,522 children and 4,991 children in both surveys. Maps illustrating provincial variation in LBW prevalence were constructed. Then, multivariate analyses were conducted to assess factors independently associated with LBW in CDHS 2014.

RESULTS

LBW prevalence remained stable between 2010 and 2014, at around 7.0% 95% CI: 5.8-8.1). all institutional births, but within significant variation across provinces. Factors independently associated with LBW included mother's no education compared with those whose mothers had secondary or higher education (AOR = 1.6, 95% CI: 1.0-2.6), babies born to mothers with < 4 antenatal care (ANC) visits during the pregnancy compared with those whose mothers had at least 4 ANC visits (AOR = 2.0, 95% CI: 1.5-2.8). Also, first-born babies were at greater risk of LBW compared with second-born babies (AOR = 1.4, 95% CI: 1.0-2.0).

CONCLUSION

The study points to key sub-populations at greater risk and regions where LBW is particularly prevalent. Programs should target provinces where LBW prevalence remains high. Illiterate women, especially those pregnant for the first time should be the program priority. The current national program policy, which recommends that pregnant women have ≥ 4 ANC visits during pregnancy should be further reinforced and implemented. Program design should consider ways to communicate the importance of making the recommended number of ANC visits among women with no formal education.

Antenatal depressive symptoms and adverse birth outcomes in Hanoi, Vietnam

BACKGROUND

Antenatal depression is a significant health problem in low and middle- income countries. Although the condition is associated with severe adverse consequences for the mother and newborn, it remains a neglected problem. The purpose of this study was to describe the association between antenatal depressive symptoms and preterm birth (PTB), low birth weight (LBW), and small for gestation age (SGA).

METHODS

The study was conducted in Dong Anh District, Hanoi, Vietnam, among pregnant women of less than 24 weeks of gestation. Information on socioeconomic characteristics and reproductive history was collected at enrollment and ADS and experiences of intimate partner violence were assessed at week 32. Birth outcomes were determined at delivery. Bivariate and logistic regression analyses were applied to assess the associations between ADS and PTB, LBW, and SGA.

RESULTS

ADS was significantly associated with an increased risk of PTB (crude OR = 2.4; 95%; CI: 1.01-5.4 and adjusted OR = 2.4; 95% CI: 1.1-5.2, respectively) and a significantly increased risk for giving birth to an LBW infant (crude OR = 3.1; 95% CI: 1.4-7.0 and adjusted OR = 3.5; 95% CI: 1.6-7.6, respectively). In contrast, ADS was not statistically associated with small for gestation age.

CONCLUSION

ADS is associated with an increased risk of PTB and LBW but not associated with SGA.

Mental disorders in pregnancy and newborn conditions: longitudinal study with pregnant women attended in primary care

This study aimed to determine the presence and association of possible mental disorders diagnoses in primary care pregnant women and newborns' conditions. This is a longitudinal study with pregnant women (18-39 years), in the second and third trimesters of pregnancy, attended at primary care facilities in the metropolitan region of São Paulo (February to August/2014). The following tools were used: sociodemographic questionnaire; Mental Disorders in Primary Care Assessment tool; and an interview with information and mother´s perception of the behavior of newborns. Of the 300 pregnant women interviewed, 76 had possible diagnosis of mental disorders, 46 women had depression/dysthymia and 58 anxiety/panic symptoms. Low birth weight and prematurity was observed in 14 and 19 newborns, respectively, and there was no association with the probable diagnosis of mental disorders; the possible presence of mental disorders was associated with the mother's perception of newborns behavior. Pregnant women attended at low risk prenatal care showed relevant frequency of mental disorders; thus, the identification of these changes during pregnancy can also contribute to a better understanding of the mother-and-child dynamics and in the quality of family care.

Intimate partner violence, forced first sex and adverse pregnancy outcomes in a sample of Zimbabwean women accessing maternal and child health care

Background

Intimate partner violence (IPV) remains a serious problem with a wide range of health consequences including poor maternal and newborn health outcomes. We assessed the relationship between IPV, forced first sex (FFS) and maternal and newborn health outcomes.

Methods

A cross sectional study was conducted with 2042 women aged 15–49 years attending postnatal care at six clinics in Harare, Zimbabwe, 2011. Women were interviewed on IPV while maternal and newborn health data were abstracted from clinic records. We conducted logistic regression models to assess the relationship between forced first sex (FFS), IPV (lifetime, in the last 12 months and during pregnancy) and maternal and newborn health outcomes.

Results

Of the recent pregnancies 27.6% were not planned, 50.9% booked (registered for antenatal care) late and 5.6% never booked. A history of miscarriage was reported by 11.5%, and newborn death by 9.4% of the 2042 women while 8.6% of recent livebirths were low birth weight (LBW) babies. High prevalence of emotional (63,9%, 40.3%, 43.8%), physical (37.3%, 21.3%, 15.8%) and sexual (51.7%, 35.6%, 38.8%) IPV ever, 12 months before and during pregnancy were reported respectively. 15.7% reported forced first sex (FFS). Each form of lifetime IPV (emotional, physical, sexual, physical/sexual) was associated with a history of miscarrying (aOR ranges: 1.26–1.38), newborn death (aOR ranges: 1.13–2.05), and any negative maternal and newborn health outcome in their lifetime (aOR ranges: 1.32–1.55). FFS was associated with a history of a negative outcome (newborn death, miscarriage, stillbirth) (aOR1.45 95%CI: 1.06–1.98). IPV in the last 12 months before pregnancy was associated with unplanned pregnancy (aOR ranges 1.31–2.02) and booking late for antenatal care. Sexual IPV (aOR 2.09 CI1.31–3.34) and sexual/physical IPV (aOR2.13, 95%CI: 1.32–3.42) were associated with never booking for antenatal care. Only emotional IPV during pregnancy was associated with low birth weight (aOR1.78 95%CI1.26–2.52) in the recent pregnancy and any recent pregnancy negative outcomes including LBW, premature baby, emergency caesarean section (aOR1.38,95%CI:1.03–1.83).

Conclusions

Forced first sex (FFS) and intimate partner violence (IPV) are associated with adverse maternal and newborn health outcomes. Strengthening primary and secondary violence prevention is required to improve pregnancy-related outcomes.

Pre-pregnancy maternal depressive symptoms and low birth weight and preterm birth outcomes: Assessment of adolescent background characteristics and birth outcomes in adulthood

PURPOSE

In the United States and other countries of the world , high prevalence of pre-pregnancy depressive symptoms and depression during pregnancy is an important public health concern, as they are associated with low birth weight (LBW) and preterm birth (PTB) outcomes in adulthood. However, the relationships among pre-pregnancy depressive symptoms, low birth weight, preterm birth outcomes and household characteristics have not been well established.

METHODS

The study used data from 7120 adolescent female participants in the National Longitudinal Study of Adolescent to Adult Health data from Waves I (1994-1995 in-school interview), II (1996 as in-home), III (2001-2002 as in-home interview), IV (2008 as in-home interview) and Wave V is currently underway. The main outcomes were LBW and PTB. Maternal depressive symptoms were assessed with the Center for Epidemiologic Studies Depression scale (CES-D) using a cut-off point of 24 to indicate higher depressive symptoms . Odds ratios were used as an estimate of the relative risk using generalized estimating equations (GEE).

RESULTS

In Wave I, prevalence of depressive symptoms among age groups 11-15 (54.1%) was higher than older adolescents (45.9%) were. With the exception of depressive symptoms reported in Wave II, respondents reporting depressive symptoms in Waves I and III had similar unadjusted rates of LBW or PTB infants in adulthood. Mothers reporting higher depressive symptoms in older adolescence (15-19 years) had elevated odds of LBW infants (3.58 [95% CI=1.81, 7.09]) in Wave III compared with others reporting low depressive symptoms.

CONCLUSIONS

Undeniably, childhood socioeconomic circumstances are important determinants of disease risks and improved health functioning and in particular birth outcomes in adulthood. Since poorer households have fewer resources to cope with stressful events that generate mood and other depressive symptoms over the life course, findings of research suggest treating depressive symptoms prior to pregnancy will yield significant dividends for mothers and society. Furthermore, without careful control of household contexts, the association between depressive symptoms and birth outcomes is likely to be confounded.

Obstetric outcomes in pregnant women with and without depression: population-based comparison

This study used insurance claims data to evaluate obstetric outcomes in pregnant women with and without depression because population study for Asian women on the issue is limited. We identified 5,064 women with depression at pregnancy in 2005–2013, and 20,024 pregnant women without depression, frequency matched by age, pregnant year and parity. Obstetric events during pregnancy and deliveries were evaluated. The depression group had more events than comparisons for hyperemesis (39.3 vs. 35.5%), abortion (3.3 vs. 2.6%), malpresentation (12.3 vs. 10.3%), C-section (40.2 vs. 34.6%) and intrauterine fetal demise (0.7 vs. 0.4%); risks of these events were significant for childbearing depressed women, not for the 35+ years subgroup. These incidences were higher in depressed women taking antidepressant than those without the medication, but were significant in childbearing depressed subgroup for hyperemesis and C-section with odds ratios of 1.18 (95% confidence intervals (CI), 1.02–1.36) and 1.29 (95% CI, 1.11–1.49), respectively. Incident preterm and low birth weight births were also higher in the depression group than in comparisons, but weren’t significant. In conclusion, women with depression during pregnancy may develop more adverse events than comparisons and are more likely to have a C-section delivery.

Maternal depression during pregnancy is associated with increased birth weight in term infants

Previous research of maternal depression during pregnancy suggests an association with low birth weight in newborns. Review of these studies reveals predominant comorbidity with premature birth. This current study examines antenatal depression and birth weight in term, medically low-risk pregnancies. Maternal physiological and demographic measures were collected as well. In total, 227 pregnant women were recruited to participate in four experimental protocols at Columbia University Medical Center. Results indicate that depressed pregnant women who carry to term had significantly higher heart rates, lower heart rate variability, and gave birth to heavier babies than those of pregnant women who were not depressed. Low income participants had significantly higher levels of depression, as well as significantly higher heart rates and lower heart rate variability, than those in higher income groups. In full-term infants, maternal prenatal depression appears to promote higher birth weight, with elevated maternal heart rate as a likely mediating mechanism.

[Association between depression during pregnancy and low birth weight in neonates: a Meta analysis]

OBJECTIVE

To study the association between depression during pregnancy and low birth weight in neonates, and to provide a scientific basis for the prevention of low birth weight.

METHODS

Cohort studies on the association between depression during pregnancy and low birth weight were collected and a Meta analysis was performed. Data were extracted independently by two investigators, and quality assessment was performed according to Newcastle-Ottawa Scale. The Egger's test was used to evaluate publication bias.

RESULTS

A total of 12 cohort studies with 37 192 samples were included. The results of the Meta analysis showed that depression during pregnancy was associated with low birth weight (Z=2.08, P=0.038), and the neonates whose mothers had depression during pregnancy tended to have a high risk of low birth weight (RR=1.303, 95%CI: 1.015-1.672). The sensitivity analysis showed that the results of this Meta analysis were stable and reliable, and the Egger's test showed no publication bias.

CONCLUSIONS

Depression during pregnancy may be a risk factor for low birth weight in neonates.

[Association between depression during pregnancy and low birth weight in neonates: a Meta analysis]

OBJECTIVE

To study the association between depression during pregnancy and low birth weight in neonates, and to provide a scientific basis for the prevention of low birth weight.

METHODS

Cohort studies on the association between depression during pregnancy and low birth weight were collected and a Meta analysis was performed. Data were extracted independently by two investigators, and quality assessment was performed according to Newcastle-Ottawa Scale. The Egger's test was used to evaluate publication bias.

RESULTS

A total of 12 cohort studies with 37 192 samples were included. The results of the Meta analysis showed that depression during pregnancy was associated with low birth weight (Z=2.08, P=0.038), and the neonates whose mothers had depression during pregnancy tended to have a high risk of low birth weight (RR=1.303, 95%CI: 1.015-1.672). The sensitivity analysis showed that the results of this Meta analysis were stable and reliable, and the Egger's test showed no publication bias.

CONCLUSIONS

Depression during pregnancy may be a risk factor for low birth weight in neonates.

Risk factors for low birth weight and preterm birth: A population-based case-control study in Wuhan, China

Low birth weight (LBW) and preterm birth (PB) are associated with newborn mortality and diseases in adulthood. We explored factors related to LBW and PB by conducting a population-based case-control study from January 2011 to December 2013 in Wuhan, China. A total of 337 LBW newborn babies, 472 PB babies, and 708 babies with normal birth weights and born from term pregnancies were included in this study. Information of newborns and their parents was collected by trained investigators using questionnaires and referring to medical records. Univariate and logistic regression analyses with the stepwise selection method were used to determine the associations of related factors with LBW and PB. Results showed that maternal hypertension (OR=6.78, 95% CI: 2.27-20.29, P=0.001), maternal high-risk pregnancy (OR=1.53, 95% CI: 1.06-2.21, P=0.022), and maternal fruit intake ≥300 g per day during the first trimester (OR=1.70, 95% CI: 1.17-2.45, P=0.005) were associated with LBW. BMI ≥24 kg/m² of mother prior to delivery (OR=0.48, 95% CI: 0.32-0.74, P=0.001) and gestation ≥37 weeks (OR=0.01, 95% CI: 0.00-0.02, P<0.034) were protective factors for LBW. Maternal hypertension (OR=3.36, 95% CI: 1.26-8.98, P=0.016), maternal high-risk pregnancy (OR=4.38, 95% CI: 3.26-5.88, P<0.001), maternal meal intake of only twice per day (OR=1.88, 95% CI: 1.10-3.20, P=0.021), and mother liking food with lots of aginomoto and salt (OR=1.60, 95% CI: 1.02-2.51, P=0.040) were risk factors for PB. BMI ≥24 kg/m² of mother prior to delivery (OR=0.66, 95% CI: 0.47-0.93, P=0.018), distance of house from road ≥36 meters (OR=0.72, 95% CI: 0.53-0.97, P=0.028), and living in rural area (OR= 0.60, 95% CI: 0.37-0.99, P=0.047) were protective factors for PB. Our study demonstrated some risk factors and protective factors for LBW and PB, and provided valuable information for the prevention of the conditions among newborns.

Prenatal Depression Risk Factors, Developmental Effects and Interventions: A Review

This narrative review based on a literature search in PubMed and PsycInfo on the two terms prenatal and antenatal depression includes empirical studies, reviews and meta-analyses that have been published during the last 5 years on risk factors, developmental effects and interventions for prenatal depression. Risk factor studies that met criteria feature demographic measures (lower socioeconomic status, less education, non-marital status, non-employment, less social support and health locus of control, unintended pregnancy, partner violence and history of child abuse) and physiological variables (cortisol, amylase, and pro-inflammatory cytokines and intrauterine artery resistance). The negative effects include postpartum depression, paternal depression, and prematurity and low birth weight. Negative effects on infants include greater right frontal EEG, amygdala connectivity, cortical thinning and more difficult temperament. In childhood, externalizing and internalizing problems have been reported. The data on prenatal antidepressants (specifically SSRIs) reveal negative effects including internalizing problems as well as a greater risk for autism spectrum disorder. Prenatal interventions that have been effective include interpersonal psychotherapy, peer support, massage therapy, yoga, tai chi, and aerobic exercise. Potential underlying mechanisms are discussed as well as methodological limitations including homogeneity of samples and lack of randomization to intervention groups. Despite these limitations, the literature highlights the need for prenatal depression screening and intervention.

Prevalence of Antenatal Depressive Symptoms and Associated Factors among Pregnant Women in Maichew, North Ethiopia: An Institution Based Study

BACKGROUND

Antenatal depression is one of the common problems during pregnancy with a magnitude of 20% to 30% globally. It can negatively endanger women's and off springs lives. As there are scarce reports on this area in Northern Ethiopia, it is important to carry out different studies that explore the magnitude of the problem and related factors in rural areas. The aim of this study is thus to assess the magnitude of antenatal depressive symptoms and associated factors among women at Maichew Town, North Ethiopia.

METHODS

A facility based cross sectional study was conducted among 196 pregnant women from April to June 2015. Pregnant women who had antenatal care follow-ups at the public health facilities were included in the study. Through proportional allocation to each facility, systematic random sampling technique was used to select the study participants. We used the local language version of Beck Depression Inventory to assess depressive symptoms with a cutoff point of 14 or more. Data was collected by trained Psychiatric Nurses; data entry and analysis were processed by SPSS window 20. The level of significance was determined using odds ratio and 95% confidence interval.

RESULTS

About 16.3% of the participants had never given birth before, and 46.4% and 42.3% were in the third and second trimesters of pregnancy respectively. Unwanted pregnancy was reported by 25.5% of the participants. Among those with previous pregnancy, 7.1% had previous obstetric complication. The magnitude of depression was 31.1%. Pregnant women with low level of income (AOR=3.66 (95%CI; 1.12, 11.96)), unmarried (AOR=4.07 (95% CI; 1.18, 14.04)) and house wives (AOR= 4.24 (1.38, 13.03)) were risk groups for depression.

CONCLUSION

Antenatal depression is a common problem; thus screening activities of depression in antenatal care services should be emphasized with more concern to unmarried women, those with low level of income and house wives.

Prenatal maternal distress affects atopic dermatitis in offspring mediated by oxidative stress

BACKGROUND

Recent evidence suggests that prenatal maternal distress increases the risk of allergic diseases in offspring. However, the effect of prenatal maternal depression and anxiety on atopic dermatitis (AD) risk remains poorly understood.

OBJECTIVE

We investigated whether prenatal maternal distress is associated with AD risk in offspring and whether the mechanism is mediated by reactive oxygen species.

METHODS

Two general population-based birth cohorts formed the study. One cohort (Cohort for Childhood Origin of Asthma and Allergic Diseases [COCOA]) consisted of 973 mother-baby dyads, and the other (Panel Study on Korean Children [PSKC]) consisted of 1531 mother-baby dyads. The association between prenatal distress and AD was assessed by using Cox proportional hazards and logistic regression models. In COCOA placental 11β-hydroxysteroid dehydrogenase type 2 and glutathione levels and serum IgE levels in 1-year-old children were measured.

RESULTS

In COCOA and PSKC AD occurred in 30.6% (lifetime prevalence) and 11.6% (1 year prevalence) of offspring, respectively. Prenatal maternal distress increased the risk of AD in offspring, both in COCOA (hazard ratio for depression, 1.31 [95% CI, 1.02-1.69]; hazard ratio for anxiety, 1.41 [95% CI, 1.06-1.89]) and PSKC (odds ratio for distress, 1.85 [95% CI, 1.06-3.25]). In COCOA both prenatal maternal depression and anxiety scores were positively related to the predicted probability of AD (P < .001 in both). Prenatal distress decreased placental glutathione to glutathione disulfide ratios (P = .037) and, especially in those who later had AD, decreased placental 11β-hydroxysteroid dehydrogenase type 2 levels (P = .010) and increased IgE levels at 1 year of age (P = .005).

CONCLUSION

Prenatal maternal depression and anxiety promote risk of AD in offspring. Maternal distress increases the predicted probability of AD. The mechanism might involve chronic stress, abnormal steroid levels, and reactive oxygen species.

Untreated depression during pregnancy: Short- and long-term effects in offspring. A systematic review

Aim of this systematic review is to assess short- and long-lasting effects of antenatal exposure to untreated maternal depressive symptoms. Pertinent articles were identified through combined searches of Science.gov, Cochrane library, and PubMed databases (through August 2015). Forty-three, selected articles revealed that untreated gestational depression and even depressive symptoms during pregnancy may have untoward effects on the developing fetus (hyperactivity, irregular fetal heart rate), newborns (increased cortisol and norepinephrine levels, decreased dopamine levels, altered EEG patterns, reduced vagal tone, stress/depressive-like behaviors, and increased rates of premature deaths and neonatal intensive care unit admission), and children (increased salivary cortisol levels, internalizing and externalizing problems, and central adiposity). During adolescence, an independent association exists between maternal antenatal mood symptoms and a slight increase in criminal behaviors. In contrast, the relationship between gestational depression and increased risks of prematurity and low birth weight remains controversial. Given this background, when making clinical decisions, clinicians should weigh the growing evidences suggesting the detrimental and prolonged effects in offspring of untreated antenatal depression and depressive symptoms during pregnancy against the known and emerging concerns associated with in utero exposure to antidepressants.

Paternal factors to the offspring birth weight: the 829 birth cohort study

OBJECTIVE

To investigate the contributions of parental, especially paternal factors to the offspring birth weight.

METHODS

Eligible 829 live-born, singleton children living in Hubei, China were recruited. Birth weight were measured immediately after birth and information about the parents were collected by face-to-face interview using questionnaire. Association between parental factors and birth weight was evaluated using univariate linear regression and multinomial logistic regression models.

RESULTS

Fathers living in the rural area had offspring with higher risk of low birth weight when compared with fathers who live in the capital city. Maternal lower education, lower gestational weight gain, being primipara and shorter gestational age were risk factors for low birth weight. In addition, Mothers with the history of chronic disease had higher risk to deliver a low birth weight baby. On the contrary, women who increased non-staple food consumption during pregnancy had higher risk to have a macrosomic pregnancy. However, lifestyle factors including diet, exercise, screen time, drinking and smoking from both maternal and paternal exhibited little influence on fetal birth weight.

CONCLUSION

Paternal as well as maternal factors exert influence on the fetal birth weight, although maternal factors make bigger contributions. Compared with socioeconomic and obstetric factors, lifestyle before and during pregnancy has less influence on fetal birth weight, suggested that special attention should be paid to antenatal care for the pregnant women with lower socioeconomic status in rural area.

Factors associated with antenatal depression in pregnant Korean females: the effect of bipolarity on depressive symptoms

BACKGROUND

This cross-sectional study sought to identify factors associated with antenatal depression in pregnant Korean females, including sociodemographic parameters, social support, social conflict, and bipolarity.

METHODS

Eighty-four pregnant women were recruited to complete questionnaires on sociodemographic factors, obstetric history, depressive symptoms, and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale. Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire.

RESULTS

Nineteen participants (22.6%) had positive Mood Disorder Questionnaire scores, suggesting the presence of bipolarity, and were significantly more likely to score high on the Edinburgh Postnatal Depression Scale. Antenatal depression was associated with bad marital communication and marital dissatisfaction.

CONCLUSION

These results suggest that spousal interactions play a significant role in antenatal depression, and pregnant women with bipolarity may be more depressed than those without bipolarity.