title: Perinatal depressive symptoms in HIV-infected versus HIV-uninfected women: a prospective study from preconception to postpartum.
abstract: OBJECTIVE
  Depression is common among HIV-infected women, predicts treatment nonadherence, and consequently may impact vertical transmission of HIV. We report findings from a study evaluating preconception, pregnancy, and postpartum depressive symptoms in HIV-infected vs. at-risk, HIV-uninfected women.
  
  
  METHODS
  We examined the prevalence and predictors of elevated perinatal (i.e., pregnancy and/or postpartum) depressive symptoms using a Center for Epidemiological Studies-Depression (CES-D) scale score of ≥16 in 139 HIV-infected and 105 HIV-uninfected women (62% African American) from the Women's Interagency HIV Study (WIHS).
  
  
  RESULTS
  The prevalence of elevated perinatal depressive symptoms did not differ by HIV serostatus (HIV-infected 44%, HIV-uninfected 50%, p=0.44). Among HIV-infected women, the strongest predictor of elevated symptoms was preconception depression (odds ratio [OR] 5.71, 95% confidence interval [CI] 2.67-12.19, p<0.001); crack, cocaine, and/or heroin use during preconception was marginally significant (OR 3.10, 95% CI 0.96-10.01, p=0.06). In the overall sample, additional significant predictors of perinatal depression included having multiple sex partners preconception (OR 2.20, 95% CI 1.12-4.32, p=0.02), use of preconception mental health services (OR 2.51, 95% CI 1.03-6.13, p=0.04), and not graduating from high school (OR 1.92, 95% CI 1.06-3.46, p=0.03).
  
  
  CONCLUSIONS
  Elevated perinatal depressive symptoms are common among HIV-infected and at-risk HIV-uninfected women. Depressive symptoms before pregnancy were the strongest predictor of perinatal symptoms. Findings underscore the importance of early and ongoing assessment and treatment to ensure low vertical transmission rates and improving postpregnancy outcomes for mothers and children.
authors: Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA. lrubin@psych.uic.edu
authors: Leah H
authors: LH
authors: Rubin
authors: Judith A
authors: JA
authors: Cook
authors: Dennis D
authors: DD
authors: Grey
authors: Kathleen
authors: K
authors: Weber
authors: Christina
authors: C
authors: Wells
authors: Elizabeth T
authors: ET
authors: Golub
authors: Rodney L
authors: RL
authors: Wright
authors: Rebecca M
authors: RM
authors: Schwartz
authors: Lakshmi
authors: L
authors: Goparaju
authors: Deborah
authors: D
authors: Cohan
authors: Melissa L
authors: ML
authors: Wilson
authors: Pauline M
authors: PM
authors: Maki
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology*; D019052:Depression, Postpartum / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008605:Mental Health Services / Q000706:statistics & numerical data; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012747:Sexual Partners; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology