title: Long-term maternal depression after expectant management of early preterm birth.
abstract: OBJECTIVE
  This study was undertaken to determine factors that affect depression after delivery of infants at the limits of viability. We hypothesized that expectantly managed mothers would have lower risk of depression several years after delivery.
  
  
  METHODS
  Charts were reviewed for deliveries in the calendar years 2003 through 2005 with a diagnosis of preterm labor, premature rupture of membranes or cervical insufficiency admitted at a gestation between 20 and 25(6/7) weeks. Surveys were sent that included the Edinburgh Postnatal Depression Scale and questions regarding care around the time of delivery.
  
  
  RESULTS
  A total of 176 patients met inclusion criteria. Of those, 36 consented and returned surveys. Of patients who were expectantly managed, none (0%) screened positive for depression, while 11 (38%) patients who were not expectantly management screened positive (p=0.08). Between 36 and 72 returned surveys would be needed for this to be significant, using p<0.05. Survey results indicated that 75% of respondents agreed hospitalization was traumatic, 78% would still attempt to delay birth, 97% would accept tocolysis, 89% agreed their child functioned similar to other children, and 77% were happy with how physicians handled their care.
  
  
  CONCLUSIONS
  Expectant management may be associated with lower risk of depression. Larger studies evaluating psychosocial effects of interventions are justified.
authors.affiliation: Department of Obstetrics and Gynecology, Good Samaritan Hospital, 375 Dixmyth Avenue, Cincinnati, OH 45220, USA. devin_namaky@trihealth.com
authors.forename: Devin
authors.initials: D
authors.lastname: Namaky
authors.forename: Jessica
authors.initials: J
authors.lastname: Herzberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Dehoop
authors.forename: Emily
authors.initials: E
authors.lastname: Jones
authors.forename: Kathy
authors.initials: K
authors.lastname: Wedig
authors.forename: Michael
authors.initials: M
authors.lastname: Marcotte
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D019052:Depression, Postpartum / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D009820:Ohio / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D018743:Perinatal Care; D011247:Pregnancy; D047928:Premature Birth / Q000523:psychology*; D011594:Psychometrics