title: Maternal Depressive Symptoms, Perceived Stress, and Fetal Growth.
abstract: OBJECTIVE
  To determine whether longitudinal fetal growth is altered among pregnant women reporting greater perceived stress or more symptoms of depression.
  
  
  METHODS
  This analysis was based on a multicenter longitudinal study of fetal growth. Women were screened at gestational ages of 8 weeks to 13 weeks 6 days for low-risk status and underwent serial sonographic examinations. At each study visit during pregnancy, women were asked to complete the Cohen Perceived Stress Scale (PSS) and Edinburgh Postpartum Depression Survey (EPDS). Growth curves for estimated fetal weight and individual biometric parameters were created by using linear mixed models with cubic splines and compared on the basis of whether women scored 15 or higher on the PSS or 10 or higher on the EPDS either at the start of or at any time during pregnancy.
  
  
  RESULTS
  Of the 2334 women enrolled in the study, 2088 (89%) and 2108 (90%) completed the PSS and EPDS, respectively, at least once in all trimesters. The longitudinal growth curves of estimated fetal weight as well as all individual biometric parameters were similar (P > .05) regardless of whether the participants reported PSS of 15 or higher or EPDS of 10 or higher in the first trimester or whether these scores persisted throughout the pregnancy. Similarly, effect modification by race/ethnicity was not statistically significant for the biometric parameters under study (P > .05 for all race/ethnicity interactions).
  
  
  CONCLUSIONS
  More depressive symptoms and greater perceived stress, as quantified by the EPDS and the PSS, respectively, are not associated with alterations in fetal growth throughout gestation.
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
authors.affiliation: University of California, Irvine, and Long Beach Memorial Medical Center/Miller Children's Hospital, Irvine, California, USA.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Wing
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Albert
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
authors.forename: Sungduk
authors.initials: S
authors.lastname: Kim
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
authors.forename: Jagteshwar
authors.initials: J
authors.lastname: Grewal
authors.affiliation: Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Constance
authors.initials: C
authors.lastname: Guille
authors.affiliation: Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Newman
authors.affiliation: Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA.
authors.forename: Edward K
authors.initials: EK
authors.lastname: Chien
authors.affiliation: University of Alabama, Birmingham, Alabama, USA.
authors.forename: John
authors.initials: J
authors.lastname: Owen
authors.affiliation: Columbia University Medical Center, New York, New York, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: D'Alton
authors.affiliation: Columbia University Medical Center, New York, New York, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Wapner
authors.affiliation: Christiana Care Health System, Newark, Delaware, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Grantz
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D047109:Fetal Development; D006801:Humans; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: depression; fetal growth; obstetric ultrasound; psychosocial; stress