The association of stillbirth with depressive symptoms 6-36 months post-delivery.

MedStar author(s):
Citation: Paediatric and Perinatal Epidemiology. 29(2):131-43, 2015 Mar.PMID: 25682858Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology, Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, N.I.H., ExtramuralSubject headings: *Depression/di [Diagnosis] | *Grief | *Stillbirth/px [Psychology] | Adult | Case-Control Studies | Depression/rh [Rehabilitation] | Female | Humans | Mass Screening | Odds Ratio | Referral and Consultation | Risk Factors | United States/ep [Epidemiology] | Women's HealthYear: 2015ISSN:
  • 1365-3016
Name of journal: Paediatric and perinatal epidemiologyAbstract: BACKGROUND: Stillbirths (> 20 weeks' gestation), which account for about 1 in 200 US pregnancies, may grieve parents deeply. Unresolved grief may lead to persistent depression.CONCLUSIONS: Improved screening for depression and referral may be needed for women's health care. Research should focus on defining optimal methods for support of women suffering stillbirth so as to lower the risk of subsequent depression.Copyright � 2015 John Wiley & Sons Ltd.METHODS: We compared depressive symptoms in 2009 (6-36 months after index delivery) among consenting women in the Stillbirth Collaborative Research Network's population-based case-control study conducted 2006-08 (n = 275 who delivered a stillbirth and n = 522 who delivered a healthy livebirth (excluding livebirths < 37 weeks, infants who had been admitted to a neonatal intensive care unit or who died). Women scoring > 12 on the Edinburgh Depression Scale were classified as currently depressed. Crude (cOR) and adjusted (aOR) odds ratios and 95% confidence intervals [CI] were computed from univariate and multivariable logistic models, with weighting for study design and differential consent. Marginal structural models examined potential selection bias due to low follow-up.RESULTS: Current depression was more likely in women with stillbirth (14.8%) vs. healthy livebirth (8.3%, cOR 1.90 [95% CI 1.20, 3.02]). However, after control for history of depression and factors associated with both depression and stillbirth, the stillbirth association was no longer significant (aOR 1.35 [95% CI 0.79, 2.30]). Conversely, for the 76% of women with no history of depression, a significant association remained after adjustment for confounders (aOR 1.98 [95% CI 1.02, 3.82]).All authors: Bann CM, Conway D, Coustan DR, Dudley DJ, Eunice Kennedy Shriver National Institute of Child Health and Human Development Stillbirth Collaborative Research Network Writing Group, Goldenberg RL, Hogue CJ, Moore JL, Parker CB, Reddy UM, Saade GR, Silver RM, Stoll BJ, Temple JR, Varner MW, Willinger MFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2016-01-15
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Journal Article MedStar Authors Catalog Article 25682858 Available 25682858

BACKGROUND: Stillbirths (> 20 weeks' gestation), which account for about 1 in 200 US pregnancies, may grieve parents deeply. Unresolved grief may lead to persistent depression.

CONCLUSIONS: Improved screening for depression and referral may be needed for women's health care. Research should focus on defining optimal methods for support of women suffering stillbirth so as to lower the risk of subsequent depression.Copyright � 2015 John Wiley & Sons Ltd.

METHODS: We compared depressive symptoms in 2009 (6-36 months after index delivery) among consenting women in the Stillbirth Collaborative Research Network's population-based case-control study conducted 2006-08 (n = 275 who delivered a stillbirth and n = 522 who delivered a healthy livebirth (excluding livebirths < 37 weeks, infants who had been admitted to a neonatal intensive care unit or who died). Women scoring > 12 on the Edinburgh Depression Scale were classified as currently depressed. Crude (cOR) and adjusted (aOR) odds ratios and 95% confidence intervals [CI] were computed from univariate and multivariable logistic models, with weighting for study design and differential consent. Marginal structural models examined potential selection bias due to low follow-up.

RESULTS: Current depression was more likely in women with stillbirth (14.8%) vs. healthy livebirth (8.3%, cOR 1.90 [95% CI 1.20, 3.02]). However, after control for history of depression and factors associated with both depression and stillbirth, the stillbirth association was no longer significant (aOR 1.35 [95% CI 0.79, 2.30]). Conversely, for the 76% of women with no history of depression, a significant association remained after adjustment for confounders (aOR 1.98 [95% CI 1.02, 3.82]).

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