title: Religiosity, spirituality, and depressive symptoms in pregnant women.
abstract: OBJECTIVE
  Depression during pregnancy has potential repercussions for both women and infants. Religious and spiritual characteristics may be associated with fewer depressive symptoms. This study examines the association between religiosity/spirituality and depressive symptoms in pregnant women.
  
  
  METHODS
  Pregnant women in three southern obstetrics practices were included in a cross sectional study evaluating religiosity, spirituality, and depressive symptoms. Symptoms of depression were measured using the Edinburgh Postnatal Depression Scale (EPDS). The depression outcome was measured in two ways: the EPDS score as a continuous outcome, and a score at or above the recommended EPDS cutoff (> 14). A wide array of potential confounders was addressed. Special attention was given to the interplay between religiosity/spirituality, social support, and depressive symptoms.
  
  
  RESULTS
  The mean EPDS score was 9.8 out of a maximum possible score of 30. Twenty-eight women (8.1%) scored above the recommended EPDS cutoff score. Overall religiosity/spirituality was significantly associated with fewer depressive symptoms when controlling for significant covariates, but there was a significant interaction such that the association became weaker as social support increased. Social support did not appear to be an important mediator (intermediate step) in the pathway between religiosity/spirituality and depressive symptoms.
  
  
  CONCLUSIONS
  Religiosity and spirituality may help protect from depressive symptoms when social support is lacking. Longitudinal research is needed to assess the directionality of the observed relationships.
authors.affiliation: Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia 29203, USA. joshua.mann@sc.edu
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Mann
authors.forename: Robert E
authors.initials: RE
authors.lastname: McKeown
authors.forename: Janice
authors.initials: J
authors.lastname: Bacon
authors.forename: Roumen
authors.initials: R
authors.lastname: Vesselinov
authors.forename: Freda
authors.initials: F
authors.lastname: Bush
mesh_terms: D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012069:Religion and Psychology; D012944:Social Support; D029181:Spirituality