Skip to main content
Erschienen in: Archives of Women's Mental Health 2/2013

01.04.2013 | Original Article

Subclinical depressive symptoms during pregnancy and birth outcome—a pilot study in a healthy German sample

verfasst von: S. Gawlik, L. Waldeier, M. Müller, A. Szabo, C. Sohn, C. Reck

Erschienen in: Archives of Women's Mental Health | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

There is a high prevalence of depression in Germany and all over the world. Maternal depressive symptoms during pregnancy have been shown in some studies to be associated with an increased risk of preterm birth and low birth weight. The influence of maternal depressive symptoms during pregnancy on preterm delivery and fetal birth weight was investigated in a prospective single-centre study. A sample of 273 healthy pregnant women was assessed for symptoms of antepartum depression. Symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ). Symptoms of anxiety were assessed using the State/Trait Anxiety Inventory. Patients who scored above the cutoff were contacted by phone for a Structured Clinical Diagnostic interview. Neonatal measurements were obtained from the birth registry of the Department of Obstetrics. Baseline data were assessed with a self-styled data sheet. Prevalence of elevated depressive symptoms was 13.2 % when measured with the EPDS and 8.4 % with the PHQ. According to DSM-IV criteria, only four (EPDS) respective two (PHQ-D) of these patients could be diagnosed with a depressive disorder and ten (EPDS) respective seven (PHQ) with an anxiety disorder. There was no significant influence on preterm birth or birth weight. Maternal depressive symptoms are self-reported. Elevated subclinical symptoms of depression and anxiety during pregnancy are common. However, this study showed no evidence that these symptoms are associated with adverse pregnancy outcome.
Literatur
Zurück zum Zitat Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 20(3):189–209, ReviewPubMedCrossRef Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 20(3):189–209, ReviewPubMedCrossRef
Zurück zum Zitat Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M (2004) Neonatal outcome following maternal antenatal depression and anxiety: a population-based study. Am J Epidemiol 159(9):872–881PubMedCrossRef Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M (2004) Neonatal outcome following maternal antenatal depression and anxiety: a population-based study. Am J Epidemiol 159(9):872–881PubMedCrossRef
Zurück zum Zitat Beeckman K, Louckx F, Putman K (2010) Determinants of the number of antenatal visits in a metropolitan region. BMC Publ Health 10:527CrossRef Beeckman K, Louckx F, Putman K (2010) Determinants of the number of antenatal visits in a metropolitan region. BMC Publ Health 10:527CrossRef
Zurück zum Zitat Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103(4):698–709, Review. Erratum in: Obstet Gynecol. 2004 Jun;103(6):1344PubMedCrossRef Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103(4):698–709, Review. Erratum in: Obstet Gynecol. 2004 Jun;103(6):1344PubMedCrossRef
Zurück zum Zitat Bergant AM, Nguyen T, Heim K, Ulmer H, Dapunt O (1998) German language version and validation of the Edinburgh postnatal depression scale. Dtsch Med Wochenschr 123(3):35–40, GermanPubMedCrossRef Bergant AM, Nguyen T, Heim K, Ulmer H, Dapunt O (1998) German language version and validation of the Edinburgh postnatal depression scale. Dtsch Med Wochenschr 123(3):35–40, GermanPubMedCrossRef
Zurück zum Zitat Bonari L, Pinto N, Ahn E, Einarson A, Steiner M, Koren G (2004) Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726–735PubMed Bonari L, Pinto N, Ahn E, Einarson A, Steiner M, Koren G (2004) Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726–735PubMed
Zurück zum Zitat Bortz J (2005) Statistik: Für Human- und Sozialwissenschaftler, 6th edn. Springer, Berlin Bortz J (2005) Statistik: Für Human- und Sozialwissenschaftler, 6th edn. Springer, Berlin
Zurück zum Zitat Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh postnatal depression scale measure anxiety? J Psychosom Res 51(5):659–663PubMedCrossRef Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh postnatal depression scale measure anxiety? J Psychosom Res 51(5):659–663PubMedCrossRef
Zurück zum Zitat Chen CH, Lin HC (2011) Prenatal care and adverse pregnancy outcomes among women with depression: a nationwide population-based study. Can J Psychiatry 56(5):273–280PubMed Chen CH, Lin HC (2011) Prenatal care and adverse pregnancy outcomes among women with depression: a nationwide population-based study. Can J Psychiatry 56(5):273–280PubMed
Zurück zum Zitat Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum, Hillsdale Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum, Hillsdale
Zurück zum Zitat Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786PubMedCrossRef Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786PubMedCrossRef
Zurück zum Zitat Cox JL, Chapman G, Murray D, Jones P (1996) Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women. J Affect Disord 39(3):185–189PubMedCrossRef Cox JL, Chapman G, Murray D, Jones P (1996) Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women. J Affect Disord 39(3):185–189PubMedCrossRef
Zurück zum Zitat Davis EP, Glynn LM, Schetter CD, Hobel C, Chicz-Demet A, Sandman CA (2007) Prenatal exposure to maternal depression and cortisol influences infant temperament. J Am Acad Child Adolesc Psychiatry 46(6):737–746PubMedCrossRef Davis EP, Glynn LM, Schetter CD, Hobel C, Chicz-Demet A, Sandman CA (2007) Prenatal exposure to maternal depression and cortisol influences infant temperament. J Am Acad Child Adolesc Psychiatry 46(6):737–746PubMedCrossRef
Zurück zum Zitat Dawson G, Ashman SB, Carver LJ (2000) The role of early experience in shaping behavioral and brain development and its implications for social policy. Dev Psychopathol 12(4):695–712PubMedCrossRef Dawson G, Ashman SB, Carver LJ (2000) The role of early experience in shaping behavioral and brain development and its implications for social policy. Dev Psychopathol 12(4):695–712PubMedCrossRef
Zurück zum Zitat Diego MA, Field T, Hernandez-Reif M, Schanberg S, Kuhn C, Gonzalez-Quintero VH (2009) Prenatal depression restricts fetal growth. Early Hum Dev 85(1):65–70PubMedCrossRef Diego MA, Field T, Hernandez-Reif M, Schanberg S, Kuhn C, Gonzalez-Quintero VH (2009) Prenatal depression restricts fetal growth. Early Hum Dev 85(1):65–70PubMedCrossRef
Zurück zum Zitat Essau CA, Lewinsohn PM, Seeley JR, Sasagawa S (2010) Gender differences in the developmental course of depression. J Affect Disord 127(1–3):185–190, Epub 2010 Jun 22PubMedCrossRef Essau CA, Lewinsohn PM, Seeley JR, Sasagawa S (2010) Gender differences in the developmental course of depression. J Affect Disord 127(1–3):185–190, Epub 2010 Jun 22PubMedCrossRef
Zurück zum Zitat Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191PubMedCrossRef Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191PubMedCrossRef
Zurück zum Zitat Faul F, Erdfelder E, Buchner A, Lang A-G (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160PubMedCrossRef Faul F, Erdfelder E, Buchner A, Lang A-G (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160PubMedCrossRef
Zurück zum Zitat Field T, Diego M, Hernandez-Reif M, Figueiredo B, Deeds O, Ascencio A, Schanberg S, Kuhn C (2010) Comorbid depression and anxiety effects on pregnancy and neonatal outcome. Infant Behav Dev 33(1):23–29PubMedCrossRef Field T, Diego M, Hernandez-Reif M, Figueiredo B, Deeds O, Ascencio A, Schanberg S, Kuhn C (2010) Comorbid depression and anxiety effects on pregnancy and neonatal outcome. Infant Behav Dev 33(1):23–29PubMedCrossRef
Zurück zum Zitat Fishell A (2010) Depression and anxiety in pregnancy. J Popul Ther Clin Pharmacol 17(3):e363–e369PubMed Fishell A (2010) Depression and anxiety in pregnancy. J Popul Ther Clin Pharmacol 17(3):e363–e369PubMed
Zurück zum Zitat Giardinelli L, Innocenti A, Benni L, Stefanini MC, Lino G, Lunardi C, Svelto V, Afshar S, Bovani R, Castellini G, Faravelli C (2012) Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Womens Ment Health 15(1):21–30PubMedCrossRef Giardinelli L, Innocenti A, Benni L, Stefanini MC, Lino G, Lunardi C, Svelto V, Afshar S, Bovani R, Castellini G, Faravelli C (2012) Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Womens Ment Health 15(1):21–30PubMedCrossRef
Zurück zum Zitat Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R (2009) A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand 119(5):350–364PubMedCrossRef Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R (2009) A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand 119(5):350–364PubMedCrossRef
Zurück zum Zitat Goedhart G, Snijders AC, Hesselink AE, van Poppel MN, Bonsel GJ, Vrijkotte TG (2010) Maternal depressive symptoms in relation to perinatal mortality and morbidity: results from a large multiethnic cohort study. Psychosom Med 72(8):769–776PubMedCrossRef Goedhart G, Snijders AC, Hesselink AE, van Poppel MN, Bonsel GJ, Vrijkotte TG (2010) Maternal depressive symptoms in relation to perinatal mortality and morbidity: results from a large multiethnic cohort study. Psychosom Med 72(8):769–776PubMedCrossRef
Zurück zum Zitat Goldenberg RL, Culhane JF, Iams JD, Romero R (2008) Epidemiology and causes of preterm birth. Lancet 371(9606):75–84PubMedCrossRef Goldenberg RL, Culhane JF, Iams JD, Romero R (2008) Epidemiology and causes of preterm birth. Lancet 371(9606):75–84PubMedCrossRef
Zurück zum Zitat Grigoriadis S, de Camps Meschino D, Barrons E, Bradley L, Eady A, Fishell A, Mamisachvili L, Cook GS, O’Keefe M, Romans S, Ross LE (2011) Mood and anxiety disorders in a sample of Canadian perinatal women referred for psychiatric care. Arch Womens Ment Health 14(4):325–333PubMedCrossRef Grigoriadis S, de Camps Meschino D, Barrons E, Bradley L, Eady A, Fishell A, Mamisachvili L, Cook GS, O’Keefe M, Romans S, Ross LE (2011) Mood and anxiety disorders in a sample of Canadian perinatal women referred for psychiatric care. Arch Womens Ment Health 14(4):325–333PubMedCrossRef
Zurück zum Zitat Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024PubMedCrossRef Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024PubMedCrossRef
Zurück zum Zitat Kaitz M, Maytal HR, Devor N, Bergman L, Mankuta D (2010) Maternal anxiety, mother–infant interactions, and infants’ response to challenge. Infant Behav Dev 33(2):136–148PubMedCrossRef Kaitz M, Maytal HR, Devor N, Bergman L, Mankuta D (2010) Maternal anxiety, mother–infant interactions, and infants’ response to challenge. Infant Behav Dev 33(2):136–148PubMedCrossRef
Zurück zum Zitat Kaplan LA, Evans L, Monk C (2008) Effects of mothers’ prenatal psychiatric status and postnatal caregiving on infant biobehavioral regulation: can prenatal programming be modified? Early Hum Dev 84(4):249–256PubMedCrossRef Kaplan LA, Evans L, Monk C (2008) Effects of mothers’ prenatal psychiatric status and postnatal caregiving on infant biobehavioral regulation: can prenatal programming be modified? Early Hum Dev 84(4):249–256PubMedCrossRef
Zurück zum Zitat Kelly RH, Russo J, Holt VL, Danielsen BH, Zatzick DF, Walker E, Katon W (2002) Psychiatric and substance use disorders as risk factors for low birth weight and preterm delivery. Obstet Gynecol 100(2):297–304PubMedCrossRef Kelly RH, Russo J, Holt VL, Danielsen BH, Zatzick DF, Walker E, Katon W (2002) Psychiatric and substance use disorders as risk factors for low birth weight and preterm delivery. Obstet Gynecol 100(2):297–304PubMedCrossRef
Zurück zum Zitat Liu Y, Murphy SK, Murtha AP, Fuemmeler BF, Schildkraut J, Huang Z, Overcash F, Kurtzberg J, Jirtle R, Iversen ES, Forman MR, Hoyo C (2012) Depression in pregnancy, infant birth weight and DNA methylation of imprint regulatory elements. Epigenetics 7(7):735–746PubMedCrossRef Liu Y, Murphy SK, Murtha AP, Fuemmeler BF, Schildkraut J, Huang Z, Overcash F, Kurtzberg J, Jirtle R, Iversen ES, Forman MR, Hoyo C (2012) Depression in pregnancy, infant birth weight and DNA methylation of imprint regulatory elements. Epigenetics 7(7):735–746PubMedCrossRef
Zurück zum Zitat Löwe B, Spitzer RL, Gräfe K, Kroenke K, Quenter A, Zipfel S, Buchholz C, Witte S, Herzog W (2004) Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. J Affect Disord 78(2):131–140PubMedCrossRef Löwe B, Spitzer RL, Gräfe K, Kroenke K, Quenter A, Zipfel S, Buchholz C, Witte S, Herzog W (2004) Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. J Affect Disord 78(2):131–140PubMedCrossRef
Zurück zum Zitat Magnusson M, Lagerberg D, Sundelin C (2011) How can we identify vulnerable mothers who do not reach the cut off 12 points in EPDS? J Child Health Care 15(1):39–49PubMedCrossRef Magnusson M, Lagerberg D, Sundelin C (2011) How can we identify vulnerable mothers who do not reach the cut off 12 points in EPDS? J Child Health Care 15(1):39–49PubMedCrossRef
Zurück zum Zitat Marcus SM (2009) Depression during pregnancy: rates, risks and consequences—Motherisk Update 2008. Can J Clin Pharmacol 16(1):e15–e22PubMed Marcus SM (2009) Depression during pregnancy: rates, risks and consequences—Motherisk Update 2008. Can J Clin Pharmacol 16(1):e15–e22PubMed
Zurück zum Zitat Marcus S, Lopez JF, McDonough S, Mackenzie MJ, Flynn H, Neal CR Jr, Gahagan S, Volling B, Kaciroti N, Vazquez DM (2011) Depressive symptoms during pregnancy: impact on neuroendocrine and neonatal outcomes. Infant Behav Dev 34(1):26–34PubMedCrossRef Marcus S, Lopez JF, McDonough S, Mackenzie MJ, Flynn H, Neal CR Jr, Gahagan S, Volling B, Kaciroti N, Vazquez DM (2011) Depressive symptoms during pregnancy: impact on neuroendocrine and neonatal outcomes. Infant Behav Dev 34(1):26–34PubMedCrossRef
Zurück zum Zitat Matthey S, Ross-Hamid C (2012) Repeat testing on the Edinburgh Depression Scale and the HADS-A in pregnancy: differentiating between transient and enduring distress. J Affect Disord. doi:10.1016/j.jad.2012.02.037 Matthey S, Ross-Hamid C (2012) Repeat testing on the Edinburgh Depression Scale and the HADS-A in pregnancy: differentiating between transient and enduring distress. J Affect Disord. doi:10.​1016/​j.​jad.​2012.​02.​037
Zurück zum Zitat Matthey S, Barnett B, Kavanagh DJ, Howie P (2001) Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. J Affect Disord 64(2–3):175–184 Matthey S, Barnett B, Kavanagh DJ, Howie P (2001) Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. J Affect Disord 64(2–3):175–184
Zurück zum Zitat Matthey S, Henshaw C, Elliott S, Barnett B (2006) Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale: implications for clinical and research practice. Arch Womens Ment Health 9(6):309–315PubMedCrossRef Matthey S, Henshaw C, Elliott S, Barnett B (2006) Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale: implications for clinical and research practice. Arch Womens Ment Health 9(6):309–315PubMedCrossRef
Zurück zum Zitat Meades R, Ayers S (2011) Anxiety measures validated in perinatal populations: a systematic review. J Affect Disord 133(1–2):1–15PubMedCrossRef Meades R, Ayers S (2011) Anxiety measures validated in perinatal populations: a systematic review. J Affect Disord 133(1–2):1–15PubMedCrossRef
Zurück zum Zitat Olkin E, Pratt JW (1958) Unbiased estimation of certain correlation coefficients. Ann Math Stat 29:201–211CrossRef Olkin E, Pratt JW (1958) Unbiased estimation of certain correlation coefficients. Ann Math Stat 29:201–211CrossRef
Zurück zum Zitat Reck C, Hunt A, Fuchs T, Weiss R, Noon A, Moehler E, Downing G, Tronick EZ, Mundt C (2004) Interactive regulation of affect in postpartum depressed mothers and their infants: an overview. Psychopathology 37(6):272–280PubMedCrossRef Reck C, Hunt A, Fuchs T, Weiss R, Noon A, Moehler E, Downing G, Tronick EZ, Mundt C (2004) Interactive regulation of affect in postpartum depressed mothers and their infants: an overview. Psychopathology 37(6):272–280PubMedCrossRef
Zurück zum Zitat Saigal S, Doyle LW (2008) An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 371(9608):261–269PubMedCrossRef Saigal S, Doyle LW (2008) An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 371(9608):261–269PubMedCrossRef
Zurück zum Zitat Salomon A et al (2001) Is clinical depression distinct from subthreshold depressive symptoms? A review of the continuity issue in depression. ResearchJ Nerv Ment Dis 189:498–506CrossRef Salomon A et al (2001) Is clinical depression distinct from subthreshold depressive symptoms? A review of the continuity issue in depression. ResearchJ Nerv Ment Dis 189:498–506CrossRef
Zurück zum Zitat Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the state-trait anxiety inventory (self-evaluation questionnaire). Consulting Psychologists Press, Palo Alto Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the state-trait anxiety inventory (self-evaluation questionnaire). Consulting Psychologists Press, Palo Alto
Zurück zum Zitat Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA 282(18):1737–1744PubMedCrossRef Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA 282(18):1737–1744PubMedCrossRef
Zurück zum Zitat Stewart RC (2007) Maternal depression and infant growth: a review of recent evidence. Matern Child Nutr 3(2):94–107, ReviewPubMedCrossRef Stewart RC (2007) Maternal depression and infant growth: a review of recent evidence. Matern Child Nutr 3(2):94–107, ReviewPubMedCrossRef
Zurück zum Zitat Strohle A, Holsboer F (2003) Stress responsive neurohormones in depression and anxiety. Pharmacopsychiatry 36:207–214 Strohle A, Holsboer F (2003) Stress responsive neurohormones in depression and anxiety. Pharmacopsychiatry 36:207–214
Zurück zum Zitat Tegethoff M, Greene N, Olsen J, Meyer AH, Meinlschmidt G (2010) Maternal psychosocial adversity during pregnancy is associated with length of gestation and offspring size at birth: evidence from a population-based cohort study. Psychosom Med 72(4):419–426PubMedCrossRef Tegethoff M, Greene N, Olsen J, Meyer AH, Meinlschmidt G (2010) Maternal psychosocial adversity during pregnancy is associated with length of gestation and offspring size at birth: evidence from a population-based cohort study. Psychosom Med 72(4):419–426PubMedCrossRef
Zurück zum Zitat Wittchen HU, Wunderlich U, Gruschwitz S, Zaudig M (1997) SCID. Structured clinical interview for DSM-IV, Axis I. Hogrefe, Goettingen Wittchen HU, Wunderlich U, Gruschwitz S, Zaudig M (1997) SCID. Structured clinical interview for DSM-IV, Axis I. Hogrefe, Goettingen
Metadaten
Titel
Subclinical depressive symptoms during pregnancy and birth outcome—a pilot study in a healthy German sample
verfasst von
S. Gawlik
L. Waldeier
M. Müller
A. Szabo
C. Sohn
C. Reck
Publikationsdatum
01.04.2013
Verlag
Springer Vienna
Erschienen in
Archives of Women's Mental Health / Ausgabe 2/2013
Print ISSN: 1434-1816
Elektronische ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-012-0320-0

Weitere Artikel der Ausgabe 2/2013

Archives of Women's Mental Health 2/2013 Zur Ausgabe

Short Communication

Post-abortion mania