Pregnant women with a history of depression and depressive symptoms who use psychiatric medication may be three times more likely to deliver prematurely, according to the Michigan-based Pregnancy Outcomes and Community Health Study.
A combination of psychiatric medication use and depression before or during pregnancy raises the risk of child delivery before 35 weeks of gestation significantly,
according to a research team from the University of Washington, University of Michigan and Michigan State University.
Further carefully planned studies to disentangle the links between preterm delivery, the use of psychotropic medications and depression should be a major clinical priority, states lead author Amelia Gavin who is a University of Washington assistant professor of social work, so women can better understand the benefits and risks of using antidepressants during pregnancy.
Kristine Siefert, co-author and Michigan professor of social work added, that causes and effects linking pregnancy, depression, and psychiatric medications still need to be separated, because the use of psychiatric medication might contribute directly to preterm delivery, or indicate a greater severity of depressive symptoms, which may contribute directly or indirectly to preterm delivery.
Their project analyzed responses of nearly 3,020 women to questions about the depressive symptoms they experienced within a week of taking the questionnaire and about their history of depression severe enough to require taking psychiatric medication. Five communities of women who received prenatal care at one of 52 participating Michigan clinics between September 1998 and June 2004, who were at least 15 years old, with no history of diabetes, and were 15 to 27 weeks pregnant joined the study.
Most of the preterm deliveries among participating women were initiated by physicians after a severe pregnancy complication, such as acute hemorrhage,
preeclampsia or poor fetal growth.
Overall, 335, or 11 percent of the women in the study, delivered preterm. Of the women who delivered preterm, 75 percent had a history of depression and 62 percent used medication in the first half of pregnancy.
The study also found, that women with a history of depression who experienced depressive symptoms during pregnancy and did not use psychiatric medication, did not face an increased risk of preterm delivery.
The team's findings have been published in the September/October issue of Women's Health Issues.
This study was funded by the National Center for Research Resources, the National Institute of Child Health and Human Development, the National Institute of Nursing Research, the March of Dimes Foundation and the Centers for Disease Control and Prevention.
