Peripartum length of stay for women with depressive symptoms during pregnancy.

BACKGROUND: Approximately 1 in 10 women suffers from depression during pregnancy. Little is known about whether antepartum depression affects a mother's length of stay at delivery. We aimed to compare peripartum length of stay in women with and without depressive symptoms during pregnancy. METHODS: This study involved secondary data analysis of a larger study exploring antepartum depression. Each subject completed the Center for Epidemiological Studies Depression Scale (CES-D). We used bivariate analyses to compare patient characteristics of women with and without an elevated CES-D, and we used a multivariate Poisson regression to evaluate predictors of length of stay. RESULTS: The study sample included 867 pregnant women. Overall, 18% of study subjects scored >or=16 on the CES-D. In bivariate analyses, a longer stay was associated with an elevated CES-D and minority race, antepartum complications, cesarean delivery, prematurity, multiple gestation, and neonatal length of stay. In the final multivariate model adjusting for sociodemographic, antepartum, and obstetric factors, an elevated CES-D was associated with a significantly longer peripartum stay (0.26 days, CI 0.04-0.48). CONCLUSIONS: Depressive symptoms during pregnancy predict an increase in peripartum length of stay.

Risk factors for depressive symptoms during pregnancy: a systematic review.

The purpose of this study was to evaluate risk factors for antepartum depressive symptoms that can be assessed in routine obstetric care. We evaluated articles in the English-language literature from 1980 through 2008. Studies were selected if they evaluated the association between antepartum depressive symptoms and > or =1 risk factors. For each risk factor, 2 blinded, independent reviewers evaluated the overall trend of evidence. In total, 57 studies met eligibility criteria. Maternal anxiety, life stress, history of depression, lack of social support, unintended pregnancy, Medicaid insurance, domestic violence, lower income, lower education, smoking, single status, and poor relationship quality were associated with a greater likelihood of antepartum depressive symptoms in bivariate analyses. Life stress, lack of social support, and domestic violence continued to demonstrate a significant association in multivariate analyses. Our results demonstrate several correlates that are consistently related to an increased risk of depressive symptoms during pregnancy.