These are the findings of study conducted by a multidisciplinary group of researchers at the University of Washington, The Ohio State University, and the University of Pittsburgh. The findings of the study appeared in the Oct. 4 issue of Archives of General Psychiatry, and participating researchers had backgrounds in social work, psychiatry, statistics, obstetrics and pediatrics.
“In the United States, the likelihood of experiencing premature birth is even greater for depressed pregnant women living in poverty than for depressed pregnant women from middle- to high-socioeconomic backgrounds,” said the lead author of the report, Dr. Nancy Grote, University of Washington (UW) research associate and professor of social work. “Poor women in America are twice as likely to experience depression, compared to other women in this country.”
Findings of the study suggest that pregnant women living in European social democracies who have clinical depression had lower rates of premature births and low birth weight than women who were pregnant and depressed in the U.S. The report also said that social democracies offering universal health care coverage tend to have fewer socioeconomic disparities in birth outcomes.
Specifically, the study noted that those living in developing nations or in poverty in the United States were less likely to receive adequate prenatal, medical and mental health services, which, in turn, could add to the harmful effects of depression during pregnancy on birth outcomes.
A common affliction during pregnancy and other key junctures of a woman’s life, clinical depression affects anywhere between nine and 23 percent of women who are pregnant.
The link between depression, pre-term birth and low birth weight has shown up in other studies, but researchers noted that the results were inconclusive and inconsistent. The researchers for this project performed a meta-analysis of all available United States and non-United States studies and used rigorous, state-of-the-art guidelines to examine the data.
Because the results affirmed the strength of the link between depression during pregnancy and negative birth outcomes, the authors suggested that universal screening for depression and ready access to mental health care during pregnancy are critical initiatives.
“Ideally, pregnant women across the socioeconomic spectrum should be checked for clinical depression, and treated appropriately,” Grote said, further explaining that work by other researchers has revealed that about 60 percent of postpartum depressions begin during pregnancy. “Maternal depression affects the fetus, the newborn, the child and the adolescent. There are pernicious effects both before and after birth.”
The study also addresses the debate over whether women should be prescribed antidepressant medication during pregnancy. Because of safety concerns over taking antidepressants, depression in pregnant women often goes untreated or is stopped for the duration of the pregnancy.
“Many news reports exaggerate the perils of taking antidepressant medication during pregnancy,” Grote said. “They seldom mention that untreated depression during pregnancy has negative birth outcomes comparable to antidepressant medication use, such as those reported in the Oct 4 paper.”
Grote noted that professional guidelines on the safety of antidepressant use during pregnancy are available from the American Congress of Obstetricians and Gynecologists (ACOG).
“We advise pregnant women to ‘speak up when you’re down,'” Grote said. “Being depressed is a treatable, medical condition. It’s not your fault. Depression can affect your health and your baby’s health.”
In addition to Grote and Bridge, the other researchers on the study were Dr. Amelia Gavin, UW School of Social Work; Dr. Jennifer L. Melville, Department of Obstetrics and Gynecology, UW School of Medicine; Dr. Satish Iyengar of the Department of Statistics at the University of Pittsburgh; and Dr. Wayne J. Katon, Department of Psychiatry and Behavioral Sciences, UW School of Medicine.
The study was supported by grants from the National Institute of Mental Health and from the National Center for Research Resources, which are both components of the National Institutes of Health (NIH) and from the NIH Roadmap for Medical Research.
Source: University of Washington