Depression Linked to Premature Births
Depressed women face a higher risk of giving birth to pre-term babies than women who are not depressed, new research shows. According to the research study, published last week in Human Reproduction journal, women with severe depression are twice as likely to deliver early (at fewer than 37 weeks) as women who are not depressed. Women with less severe depression are 60 percent more likely to give birth prematurely.
Study researchers interviewed 791 members of Kaiser Permanente, a health insurance company, from October 1996 through October 1998, at their 10th week of pregnancy, and assessed the severity of their depression symptoms. Forty-one percent of the women had "significant" or "severe" depression symptoms. Although the article describing the study didn't specifically say so, I assume that the researchers had access to their medical records and were able to subsequently determine which women had pre-term births.
This study is a step in the right direction, although we still don't know why depressed women are more likely to have premature babies. The study's author, De-Kun Li, said that one possible explanation has to do with depression causing the hormones to react negatively to the placenta.
To my mind, there are two other possible explanations. One, there was another factor present in the depressed women in addition to the depression. Perhaps they were also under extreme stress, and that accounted for the pre-term birth. Another explanation for the pre-term deliveries is that depression led these women to neglect their health and well-being, which is fairly common.
Any woman with a history of depression should make sure that her OB/GYN is willing to work closely with her mental health provider during her pregnancy. In addition, OB/GYNs should be well versed in the signs of depression so they will be more likely to recognize it in women who have not previously been diagnosed. It should be routine to screen for depression, in the same way that it's routine to screen for gestational diabetes if a woman is over a certain age and/or has a family history of diabetes.
If you are experiencing depression during your pregnancy, you should talk to your doctor about it immediately. It's possible that it can be treated with talk therapy, exercise or stress relief. In severe cases, antidepressants may be called for. Women and their doctors should not simply assume that antidepressants are verboten during pregnancy. Each case has to be looked at separately, as each woman and each pregnancy is different.
My depression (and Multiple Sclerosis and age) put my pregnancy in the high risk category. When my husband and I decided to try to conceive, I talked to my psychiatrist. He reviewed the information for my antidepressant and told me to call him when I conceived. He would then help me to taper off my antidepressant, and I was to call him immediately if I started feeling depressed. I was fortunate in that I did not have any depression symptoms during my pregnancy. For some women, pregnancy seems to be an insulator against depression. Perhaps the change in hormones can beneficially affect mood disorders. Actually, this doesn't surprise me, as I found out that pregnancy seems to protect a woman against relapses of Multiple Sclerosis, which I found to be true. I had no relapses or new symptoms during my pregnancy.
It's hard to admit to being depressed while you're pregnant, especially if it's something new for you. The whole "glowing with happiness" fantasy may be hard to let go of. But I think that this study, despite its lack of answers, shows that underestimating the impact of depression on pregnancy is dangerous.