Change in depressive symptoms during pregnancy: Relationship to birth outcome

Objective: To test the hypothesis that adolescents who experience a decrease in depressive symptomatology during gestation give birth to larger, gestationally older infants than do adolescents who do not experience a decrease in depressive symptomatology during gestation.

Method: We studied 122 poor, black 12- through 19-year-olds enrolled in an adolescent-oriented prenatal program. The subjects completed two psychological evaluations during gestation. Infant birth weight and gestational age were analyzed in relation to change in depressive symptomatology.

Results: We found no relationship between change in depressive symptomatology and maternal age, socioeconomic status, adequacy of prenatal care, living arrangements, gestational weight gain, or substance abuse. At enrollment, subjects who experienced a decrease in depressive symptoms during gestation had significantly higher depression and worry scores and significantly lower social support scores. During gestation these young women reported a more significant decrease in worries and increase in family support than did young women who did not experience a decrease in depressive symptoms during gestation. Change in depressive symptomatology was also significantly related to the duration of gestation (r = 0.26; p = 0.004).

Conclusions: This study suggests that changes in the intensity of maternal psychological distress during gestation may be associated with changes in maternal social support and measurable biologic effects on the fetus.