title: Symptoms of Depression Predict Negative Birth Outcomes in African American Women: A Pilot Study.
abstract: BACKGROUND
  African American women have higher rates of preterm birth and low-birth-weight infants compared with non-Hispanic white women. Symptoms of depression have also been related to these negative birth outcomes. Lower levels of social support and higher levels of avoidance coping and cortisol have been related to more symptoms of depression in pregnant women. The purpose of this pilot study was to examine the relationships among symptoms of depression, social support, avoidance coping, cortisol, and negative birth outcomes (ie, preterm birth, low-birth-weight infants) in a sample of African American women.
  
  
  METHODS
  This study used a prospective design. A convenience sample of 90 African American women completed questionnaires and had blood drawn in the second trimester of pregnancy. Birth data were collected from medical records.
  
  
  RESULTS
  Based on the Center for Epidemiological Studies-Depression (CES-D) Scale scores, 28% of women were at increased risk for clinical depression (CES-D ≥ 16). Compared to women who gave birth at term, women who had preterm birth had higher CES-D scores (11.67 and 19.0, respectively) and used avoidance coping more often (7.98 and 13.14, respectively). Compared to women with normal-birth-weight infants, women with low-birth-weight infants had higher levels of cortisol (61.75 mcg/dL and 89.72 mcg/dL, respectively). Women at increased risk for clinical depression were 16 times more likely to have preterm birth and 4 times more likely to have low-birth-weight infants. Women with plasma cortisol levels in the top 25th percentile were 7 times more likely to have low-birth-weight infants. Preeclampsia during pregnancy also predicted preterm birth and low-birth-weight infants.
  
  
  CONCLUSIONS
  Symptoms of depression in pregnancy may predict adverse birth outcomes. Interventions that have the potential to improve the mental health of pregnant women and ultimately birth outcomes need to be explored.
authors.forename: Carmen
authors.initials: C
authors.lastname: Giurgescu
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Engeland
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Templin
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001724:Birth Weight; D003863:Depression / Q000097:blood / Q000150:complications*; D003866:Depressive Disorder / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007230:Infant, Low Birth Weight; D008603:Mental Health; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000523:psychology; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D012306:Risk; D012944:Social Support; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: African American; cortisol; depression symptoms; low-birth-weight infants; preterm birth