title: No association between antenatal common mental disorders in low-obstetric risk women and adverse birth outcomes in their offspring: results from the CDS study in Ghana and Côte D'Ivoire.
abstract: BACKGROUND
  Evidence linking common mental disorders (CMD) in pregnant women to adverse birth outcomes is inconsistent, and studies often failed to control for pregnancy complications. This study aimed to explore the association between antenatal depression and anxiety symptoms and birth outcomes in a low-obstetric risk sample of mother/child dyads in Ghana and Côte d'Ivoire.
  
  
  METHODS
  In 2010-2011, a prospective cohort of 1030 women in their third trimester in Ghana and Côte d'Ivoire was enrolled. Depression and anxiety were assessed in the third trimester using the Patient Health Questionnaire depression module and the 7-item Generalized Anxiety Disorder scale. 719 mother/child dyads were included in the analysis. We constructed multivariate regression models to estimate the association between CMD and low birth weight (LBW), and preterm birth (PTB) to control for potential confounders.
  
  
  RESULTS
  The prevalence of depression and anxiety symptoms were 28.9% and 14.2% respectively. The mean birth weight was 3172.1g (SD 440.6) and the prevalence of LBW was 1.7%. The mean gestational age was 39.6 weeks and the proportion of PTB was 4%. Multivariate linear regression revealed no significant association between maternal depression (B=52.2, 95% CI -18.2 122.6, p=0.15) or anxiety (B=17.1, 95% CI -74.6 108.7, p=0.72) and birth weight. Yet, low socio-economic status, female sex of the child, and younger maternal age were associated with lower birth weight. Multivariate logistic regression suggested no significant association between maternal depression (OR: 2.1, 95% CI 0.8 5.6, p=0.15) or anxiety (OR: 1.8, 95% CI 0.6 5.5, p=0.29) with PTB.
  
  
  CONCLUSIONS
  Our data suggests that depression and/or anxiety in the 3(rd) trimester of pregnancy are not independent predictors of adverse birth outcomes in low obstetric risk women. The role of pregnancy complications as confounders or effect modifiers in studies of maternal CMD and their impact on birth outcomes should be investigated.
authors.affiliation: Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Bindt
authors.forename: Nan
authors.initials: N
authors.lastname: Guo
authors.forename: Marguerite Te
authors.initials: MT
authors.lastname: Bonle
authors.forename: John
authors.initials: J
authors.lastname: Appiah-Poku
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hinz
authors.forename: Dana
authors.initials: D
authors.lastname: Barthel
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schoppen
authors.forename: Torsten
authors.initials: T
authors.lastname: Feldt
authors.forename: Claus
authors.initials: C
authors.lastname: Barkmann
authors.forename: Mathurin
authors.initials: M
authors.lastname: Koffi
authors.forename: Wibke
authors.initials: W
authors.lastname: Loag
authors.forename: Samuel Blay
authors.initials: SB
authors.lastname: Nguah
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Eberhardt
authors.forename: Harry
authors.initials: H
authors.lastname: Tagbor
authors.forename: Eliezer
authors.initials: E
authors.lastname: N'goran
authors.forename: Stephan
authors.initials: S
authors.lastname: Ehrhardt
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D007560:Cote d'Ivoire / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D001523:Mental Disorders / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult