title: The association of stillbirth with depressive symptoms 6-36 months post-delivery.
abstract: BACKGROUND
  Stillbirths (≥ 20 weeks' gestation), which account for about 1 in 200 US pregnancies, may grieve parents deeply. Unresolved grief may lead to persistent depression.
  
  
  METHODS
  We compared depressive symptoms in 2009 (6-36 months after index delivery) among consenting women in the Stillbirth Collaborative Research Network's population-based case-control study conducted 2006-08 (n = 275 who delivered a stillbirth and n = 522 who delivered a healthy livebirth (excluding livebirths < 37 weeks, infants who had been admitted to a neonatal intensive care unit or who died). Women scoring > 12 on the Edinburgh Depression Scale were classified as currently depressed. Crude (cOR) and adjusted (aOR) odds ratios and 95% confidence intervals [CI] were computed from univariate and multivariable logistic models, with weighting for study design and differential consent. Marginal structural models examined potential selection bias due to low follow-up.
  
  
  RESULTS
  Current depression was more likely in women with stillbirth (14.8%) vs. healthy livebirth (8.3%, cOR 1.90 [95% CI 1.20, 3.02]). However, after control for history of depression and factors associated with both depression and stillbirth, the stillbirth association was no longer significant (aOR 1.35 [95% CI 0.79, 2.30]). Conversely, for the 76% of women with no history of depression, a significant association remained after adjustment for confounders (aOR 1.98 [95% CI 1.02, 3.82]).
  
  
  CONCLUSIONS
  Improved screening for depression and referral may be needed for women's health care. Research should focus on defining optimal methods for support of women suffering stillbirth so as to lower the risk of subsequent depression.
authors: School of Public Health and School of Medicine, Emory University, Atlanta, GA.
authors: Carol J R
authors: CJ
authors: Hogue
authors: Corette B
authors: CB
authors: Parker
authors: Marian
authors: M
authors: Willinger
authors: Jeff R
authors: JR
authors: Temple
authors: Carla M
authors: CM
authors: Bann
authors: Robert M
authors: RM
authors: Silver
authors: Donald J
authors: DJ
authors: Dudley
authors: Janet L
authors: JL
authors: Moore
authors: Donald R
authors: DR
authors: Coustan
authors: Barbara J
authors: BJ
authors: Stoll
authors: Uma M
authors: UM
authors: Reddy
authors: Michael W
authors: MW
authors: Varner
authors: George R
authors: GR
authors: Saade
authors: Deborah
authors: D
authors: Conway
authors: Robert L
authors: RL
authors: Goldenberg
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003863:Depression / Q000175:diagnosis* / Q000534:rehabilitation; D005260:Female; D006117:Grief; D006801:Humans; D008403:Mass Screening; D016017:Odds Ratio; D012017:Referral and Consultation; D012307:Risk Factors; D050497:Stillbirth / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D016387:Women's Health
keywords: African Americans; Stillbirth; depression; follow-up studies; grief