Antenatal depressive symptoms and adverse perinatal outcomes

Abstract Background The association of antenatal depression with adverse pregnancy, birth, and postnatal outcomes has been an item of scientific interest over the last decades. However, the evidence that exists is controversial or limited. We previously found that one in five women in Kuwait experience antenatal depressive symptoms. Therefore, the aim of this study was to examine whether antenatal depressive symptoms are associated with preterm birth (PTB), small for gestational age (SGA), or large for gestational age (LGA) babies in this population. Methods This was a secondary analysis based on data collected in the Transgenerational Assessment of Children’s Environmental Risk (TRACER) Study that was conducted in Kuwait. Logistic regression analysis was used to examine whether antenatal depressive symptoms assessed using the Edinburgh Depression Scale (EDS) were associated with preterm birth, small for gestational age, and large for gestational age babies. Results A total of 1694 women had complete information about the outcomes of interest. Women with depressive symptoms in pregnancy had increased, albeit non-significant, odds of having PTB (OR = 1.41; 95%CI: 0.81, 2.45), SGA babies (OR = 1.26; 0.80, 1.98), or LGA babies (OR = 1.27; 0.90, 1.79). Antenatal depressive symptoms had similar increased odds for the three outcomes even after adjusting for several covariates though none of these reached statistical significance. Conclusions In the present study, the depressive symptoms in pregnancy did not predict adverse birth outcomes, such as PTB, SGA, and LGA, which adds to the currently non-conclusive literature. However, further research is needed to examine these associations, as the available evidence is quite limited.

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Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India

Wellcome Open Research ◽

10.12688/wellcomeopenres.14618.2 ◽

2019 ◽

Vol 3 ◽

pp. 76 ◽

Cited By ~ 1

Author(s):

Giridhara R. Babu ◽

G.V.S. Murthy ◽

Yogesh Reddy ◽

R. Deepa ◽

A. Yamuna ◽

...

Keyword(s):

Depressive Symptoms ◽

Gestational Age ◽

Small For Gestational Age ◽

Low Birthweight ◽

Strong Association ◽

Depression Scale ◽

Antenatal Clinic ◽

Large For Gestational Age ◽

Antenatal Depressive Symptoms ◽

Obstetric Factors

Background: Annually, more than a million Low birthweight (LBW) are born in India, often afflicting disadvantaged families. Several studies have undertaken association of poverty, nutritional status, and obstetric factors with LBW. Through our study, we aimed to examine the possibility of any relation between Edinburgh Postnatal Depression Scale (EPDS) score measured during pregnancy with incidence of babies born Small for Gestational Age (SGA). Moreover, we explored if there is any utility for identifying a cut-off point of EPDS for predicting SGA. Methods: Pregnant women attending the antenatal clinic at a public hospital between 14 to 32 weeks were recruited from April 2016 to Oct 2017. The EPDS was administered to assess depression through face-to-face interviews. Newborn anthropometry was performed post-delivery. For analysis, birth weight <10 percentile was classified as SGA and >90th percentile as Large for Gestational Age (LGA). Results: Prevalence of depressive symptoms (EPDS score >11) was 16.5% (n=108/654) in antenatal mothers. These women delivered a higher proportion of SGA babies (21.3 v/s 15.8) and LGA (9.3 v/s 3.3) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11 (adjusted OR = 2.03; 95% CI = 1.12 – 3.70) compared to the women with EPDS scores of ≤11. In terms of Area under curve (AUC), EPDS 11 cut off (AUC: 0.757, CI 0.707- 0.806) was same as EPDS 12 cut-off (AUC: 0.757, CI 0.708- 0.807), which was slightly lower than EPDS 13 cut off (AUC: 0.759 CI 0.709- 0.809). Conclusions: We found a strong association of antenatal depressive symptoms during pregnancy with SGA measured by EPDS. Thus, we recommend implementation of timely and effective screening, diagnostic services, and evidence-based antenatal mental health services in order to combat SGA, and further associated-metabolic syndromes.

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Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India

Wellcome Open Research ◽

10.12688/wellcomeopenres.14618.3 ◽

2020 ◽

Vol 3 ◽

pp. 76

Author(s):

Giridhara R. Babu ◽

G.V.S. Murthy ◽

Yogesh Reddy ◽

R. Deepa ◽

A. Yamuna ◽

...

Keyword(s):

Depressive Symptoms ◽

Gestational Age ◽

Small For Gestational Age ◽

Low Birthweight ◽

Strong Association ◽

Depression Scale ◽

Antenatal Clinic ◽

P Value ◽

Antenatal Depressive Symptoms ◽

Obstetric Factors

Background: Annually, more than a million low birthweight (LBW) is born in India, often afflicting disadvantaged families. Several studies have undertaken the association of poverty, nutritional status, and obstetric factors with LBW. Through our study, we aimed to examine the possibility of any relation between the Edinburgh Postnatal Depression Scale (EPDS) score measured during pregnancy with the incidence of babies born Small for Gestational Age (SGA). Methods: Pregnant women attending the antenatal clinic at a public hospital between 14 to 32 weeks were recruited from April 2016 to Oct 2017. The EPDS was administered to assess depression through face-to-face interviews. Newborn anthropometry was performed post-delivery. For analysis, birth weight <10 percentile was classified as SGA. Results: Prevalence of depressive symptoms (EPDS score >11) was 16.5% (n=108/654) in antenatal mothers. These women delivered a higher proportion of SGA babies (21.3 v/s 15.8) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11 (adjusted OR = 2.03; 95% CI = 1.12 – 3.70) compared to the women with EPDS scores of ≤11, The EPDS 12 (Adjusted OR = 1.96; 95% CI = 1.04 – 3.69) and EPDS 13 (Adjusted OR = 2.42; 95% CI = 1.24 – 4.70) cut-off categories also proved to be a risk factor for SGA with significant p-value (0.0006 and 0.0003) and the individuals with more than 13 EPDS score is found to have the highest odds of SGA. Conclusions: We found a strong association of antenatal depressive symptoms during pregnancy with SGA measured by EPDS. Thus, we recommend the implementation of timely and effective screening, diagnostic services, and evidence-based antenatal mental health services to combat SGA and further associated-metabolic syndromes.

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Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India

Wellcome Open Research ◽

10.12688/wellcomeopenres.14618.1 ◽

2018 ◽

Vol 3 ◽

pp. 76 ◽

Cited By ~ 5

Author(s):

Giridhara R. Babu ◽

G.V.S. Murthy ◽

Yogesh Reddy ◽

R. Deepa ◽

A. Yamuna ◽

...

Keyword(s):

Depressive Symptoms ◽

Gestational Age ◽

Small For Gestational Age ◽

Low Birthweight ◽

Depression Scale ◽

Antenatal Depression ◽

Large For Gestational Age ◽

Appropriate For Gestational Age ◽

Obstetric Factors ◽

National Programs

Background: More than one million babies are born with Low birthweight (LBW) in India every year, often afflicting disadvantaged families. Earlier studies on LBW in India have mostly focused on addressing poverty, nutritional status, and obstetric factors for LBW babies, comprising of preterm babies (<37 weeks) or small for gestational age (SGA) or both. We aim to find the association between antepartum depression and SGA in a public hospital. Methods: Pregnant women with gestational age between 14 to 32 weeks were recruited. The Edinburgh Postnatal Depression Scale (EPDS) was administered to assess depression. Newborn anthropometry was performed soon after delivery. Birth weight less than 10 percentile were classified as SGA, between 10 to 90th percentile was appropriate for gestational age (AGA), and greater than 90th percentile was large for gestational age (LGA). Results: We found that 16.51% (108) of the antenatal mothers had depressive symptoms (EPDS score >11). The women with depressive symptoms delivered a greater proportion of SGA babies (21.3 v/s 15.8) and LGA (9.3 v/s 3.3) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11 (adjusted OR = 2.18; 95% CI = 1.23 – 3.87) compared to the women with EPDS scores of ≤11. In terms of Area under curve (AUC), EPDS 11 cut off (AUC: 0.533) narrowly outperformed EPDS 12 cut-off (AUC: 0.4738), which in turn was better than EPDS 13 cut off (AUC: 0.4687) for screening depression in mothers. Conclusions: We have demonstrated the usefulness of the 10-item EPDS screening tool in screening for symptoms of antenatal depression. There is a need to explore implementation of screening, diagnostic services and evidence-based antenatal mental health services by modifying the provisions of ongoing national programs.

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High Fetal Fraction on First Trimester Cell-Free DNA Aneuploidy Screening and Adverse Pregnancy Outcomes

American Journal of Perinatology ◽

10.1055/s-0039-1694005 ◽

2019 ◽

Vol 37 (01) ◽

pp. 008-013 ◽

Cited By ~ 4

Author(s):

Lydia L. Shook ◽

Mark A. Clapp ◽

Penelope S. Roberts ◽

Sarah N. Bernstein ◽

Ilona T. Goldfarb

Keyword(s):

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

First Trimester ◽

Hypertensive Disorders Of Pregnancy ◽

Aneuploidy Screening ◽

Hypertensive Disorders ◽

Increased Risk ◽

Adverse Pregnancy ◽

Fetal Fraction

Abstract Objective To test the hypothesis that high fetal fraction (FF) on first trimester cell-free deoxyribonucleic acid (cfDNA) aneuploidy screening is associated with adverse perinatal outcomes. Study Design This is a single-institution retrospective cohort study of women who underwent cfDNA screening at <14 weeks' gestation and delivered a singleton infant between July 2016 and June 2018. Women with abnormal results were excluded. Women with high FF (≥95th percentile) were compared with women with normal FF (5th–95th percentiles). Outcomes investigated were preterm birth, small for gestational age, and hypertensive disorders of pregnancy. Results A total of 2,033 women met inclusion criteria. The mean FF was 10.0%, and FF >16.5% was considered high (n = 102). Women with high FF had a greater chance of delivering a small for gestational age infant <fifth percentile, with an adjusted odds ratio of 2.4 (95% confidence interval: 1.1–4.8, p = 0.039). There was no significant association between high FF and either preterm birth or hypertensive disorders of pregnancy. Conclusion Women with a high FF in the first trimester are at increased risk of delivering a small for gestational age infant <fifth percentile. Further investigation into the clinical implications of a high FF is warranted.

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Spontaneous Preterm Birth and Small for Gestational Age Infants in Women Who Stop Smoking Early in Pregnancy: Prospective Cohort Study

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000370503.15340.65 ◽

2010 ◽

Vol 30 (2) ◽

pp. 91-92

Author(s):

L.M. McCowan ◽

G.A. Dekker ◽

E. Chan ◽

A. Stewart ◽

L.C. Chappell ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Prospective Cohort Study ◽

Gestational Age ◽

Small For Gestational Age ◽

Prospective Cohort ◽

Spontaneous Preterm Birth ◽

Stop Smoking ◽

In Pregnancy

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The duration of estrogen treatment before progesterone application does not affect neonatal and perinatal outcomes in single frozen blastocyst transfer cycles

10.21203/rs.3.rs-877891/v1 ◽

2021 ◽

Author(s):

Mingze Du ◽

Junwei Zhang ◽

Xiaona Yu ◽

Jiaheng Li ◽

Xinmi Liu ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Gestational Age ◽

Treatment Duration ◽

Statistical Significance ◽

Perinatal Outcomes ◽

Perinatal Period ◽

Estrogen Treatment ◽

Blastocyst Transfer ◽

Large For Gestational Age

Abstract Background: The number of frozen embryo transfer (FET) cycles has substantially increased in the past decade. Preparing the endometrium in artificial cycles is widely used in clinical practice. Therefore, how to optimize this program, improve the clinical outcome and ensure the safety of the perinatal period is the focus of our attention. The purpose of this study was to explore whether the duration of estrogen treatment before progesterone application affects neonatal and perinatal outcomes in single frozen blastocyst transfer cycles.Methods: It was a retrospective cohort study. Patients receiving single frozen blastocyst transfer and delivering a single live birth between January 2015 and December 2019 were included. Primary outcome was small for gestational age (SGA). Secondary outcomes were neonatal birthweight, gestational weeks at delivery, preterm birth, low birth weight (LBW), macrosomia, large for gestational age (LGA), neonatal malformation and rate of pregnancy-related complications.Cycles were allocated to four groups according to the estrogen-treatment duration before single frozen blastocyst transfer ①≤12 days (n=306), ②13-15 days (n=620), ③16-18 days (n=471), ④≥19 days (n=275).Results: In total, 1672 cycles were analyzed. Cycles were allocated to four groups according to the estrogen-treatment duration before single frozen blastocyst transfer ①≤12 days (n=306), ②13-15 days (n=620), ③16-18 days (n=471), ④≥19 days (n=275). The rates of SGA among the four groups were 7.8% (24/306), 4.8% (30/620), 5.7% (27/471), and 7.6% (21/275), with no statistical significance (P=0.20). Other neonatal outcomes, including mean neonatal birth weight, gestational weeks at delivery, preterm birth rate, LBW, macrosomia, LGA and neonatal malformation, were comparable among the groups (P=0.38, P=0.16, P=0.20, P=0.58, P=0.20, P=0.34, P=0.96). The rate of pregnancy-related complications was similar among the groups. Multiple logistics regression showed that the duration of estrogen treatment did not affect the rate of singleton SGA (13-15 days, AOR=1.37, 95% CI= 0.70-2.70, P=0.36; 16-18 days, AOR=0.74, 95% CI= 0.40-1.36, P=0.34; ≥19 days, AOR=0.81, 95% CI= 0.44-1.49, P=0.50).Conclusion: The estrogen-treatment duration before progesterone application does not affect neonatal and perinatal outcomes in single frozen blastocyst transfer cycles.

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Mood Symptoms and Other Maternal Factors in Pregnancy and Adverse Neonate Outcomes

10.21203/rs.3.rs-61702/v1 ◽

2020 ◽

Author(s):

Hua Li ◽

Angela Bowen ◽

Rudy Bowen ◽

Nazeem Muhajarine ◽

Lloyd Balbuena

Keyword(s):

Social Support ◽

Statistical Significance ◽

Depression Scale ◽

Neonatal Outcomes ◽

Maternal Factors ◽

Mood Instability ◽

Mood Symptoms ◽

Antenatal Depressive Symptoms ◽

Adverse Neonatal Outcomes ◽

In Pregnancy

Abstract Background Antenatal women experience a higher level of mood symptoms, which have negative effects on mothers’ mental and physical health and their newborns. The relation of maternal moods including depression and anxiety and other maternal factors in pregnancy and neonate outcomes are well-studied with inconsistent findings. Although antenatal women experience a higher level of mood instability (MI), the association between antenatal MI and neonatal outcomes has not been investigated. We aimed to address this gap and to contribute to the pregnancy-neonate outcomes literature by examining the relationship between antenatal mood symptoms and other maternal factors and neonatal outcomes.Methods A prospective cohort of women (n = 555) participated in this study at early pregnancy (T1, 17.4 ± 4.9 weeks) and late pregnancy (T2, 30.6 ± 2.7 weeks). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal depressive symptoms, the EPDS anxiety subscale was utilized to measure anxiety symptoms, and mood instability was measured using a visual analogue scale. These mood states together with stress, social support, as well as healthy and unhealthy behaviours were also examined in relation to neonatal outcomes using chi-square tests and logistic regression models. Results Depression and MI were unrelated to adverse neonatal outcomes and anxiety was related to Apgar score with marginal statistical significance. Higher stress, lack of partner support, smoking, and primiparous status were associated with some adverse outcomes.Conclusions The current study identified no associations between antenatal mood symptoms and neonatal outcomes. Our findings further support and extend previous evidence on smoking abstinence or cessation, and the provision of resources for stress management and social support that could help prevent or alleviate adverse neonatal outcomes.

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