Maternal depression and physical health problems in early pregnancy: findings of an Australian nulliparous pregnancy cohort study.

Midwifery

PubMedID: 22361009

Perlen S, Woolhouse H, Gartland D, Brown SJ. Maternal depression and physical health problems in early pregnancy: findings of an Australian nulliparous pregnancy cohort study. Midwifery. 2013;29(3):233-9.
OBJECTIVE
to investigate the relationship between physical health problems and depressive symptoms in early pregnancy.

DESIGN
baseline questionnaire, prospective pregnancy cohort study.

SETTING
six metropolitan public maternity hospitals in Victoria, Australia.

PARTICIPANTS
1507 nulliparous women recruited in early pregnancy.

FINDINGS
nine per cent of women (131/1500) scored = 13 on the EPDS indicating probable clinical depression in early pregnancy (mean gestation=15 weeks). The five most commonly reported physical health problems were as follows: exhaustion (86.9%), morning sickness (64.3%), back pain (45.6%), constipation (43.5%) and severe headaches or migraines (29.5%). Women scoring = 13 on the EPDS reported a mean of six physical health problems compared with a mean of 3.5 among women scoring <13 on the EPDS. Women reporting five or more physical health problems had a three-fold increase in likelihood of reporting depressive symptoms (Adj OR=3.13, 95% CI 2.14-4.58) after adjusting for socio-demographic factors, including maternal age.

CONCLUSIONS
the findings from this large multi-centre study show that women experiencing a greater number of physical health problems are at increased risk of reporting depressive symptoms in early pregnancy.

IMPLICATIONS FOR PRACTICE
early detection and support for women experiencing physical and psychological health problems in pregnancy is an important aspect of antenatal care. The extent of co-morbid physical and psychological health problems underlines the need for comprehensive primary health care as an integral component of antenatal care.