title: Maternal depression and physical health problems in early pregnancy: findings of an Australian nulliparous pregnancy cohort study.
abstract: OBJECTIVE
  to investigate the relationship between physical health problems and depressive symptoms in early pregnancy.
  
  
  METHODS
  baseline questionnaire, prospective pregnancy cohort study.
  
  
  METHODS
  six metropolitan public maternity hospitals in Victoria, Australia.
  
  
  METHODS
  1507 nulliparous women recruited in early pregnancy.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Melbourne, Victoria 3052, Australia. susan.perlen@mcri.edu.au
authors.forename: Susan
authors.initials: S
authors.lastname: Perlen
authors.forename: Hannah
authors.initials: H
authors.lastname: Woolhouse
authors.forename: Deirdre
authors.initials: D
authors.lastname: Gartland
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Brown
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D061345:Early Medical Intervention / Q000379:methods; D005260:Female; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006801:Humans; D008423:Maternal Age; D008427:Maternal Health Services / Q000706:statistics & numerical data; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011261:Pregnancy Trimester, First / Q000523:psychology*; D011295:Prenatal Care / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D014739:Victoria / Q000453:epidemiology