Stacy Coates Hodgkinson, MA Kennedy Krieger Institute

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Presentation transcript:

Stacy Coates Hodgkinson, MA Kennedy Krieger Institute MATERNAL DEPRESSION, SUICIDALITY AND BIRTH OUTCOMES AMONG PREGNANT TEENAGERS Stacy Coates Hodgkinson, MA Howard University Kennedy Krieger Institute

Depression and Pregnancy Between 2 and 20% of pregnant women experience some degree of depression. Among pregnant adolescents and women of lower SES, rates have been reported between 40 and 50%. Among pregnant women who are depressed, rates of suicidal ideation have ranged from 3% to 17.6%. Bennett et al., 2004; Miller, 1998

Depression and Birth Outcomes Untreated depression can have adverse effects on fetal health. Pre-eclampsia (pregnancy induced hypertension) Spontaneous abortion Decreased fetal activity Psychopathology in offspring Infant birth weight (less than 2500 grams) and Preterm delivery (less than 37 weeks) Bennett et al., 2004; Bonari et al., 2004; Chung et al., 2001; Orr and Miller, 1995

Objectives 1. To determine the prevalence of self-reported depression symptoms 2. To determine if there are differences in gestational age and infant birth weight among pregnant adolescents reporting depression symptoms 3. To determine if there are any differences in birth outcomes among adolescents reporting more severe depression symptoms

Method and Procedures Teen Alliance for Pregnancy Prevention (TAPP) N = 294 pregnant adolescents Retrospective review of medical and program records

Procedure The principal measure of depression was five questions related to depression symptomotology included in a 40-item intake utilized by the program as a psychosocial assessment. 1. Do you feel bad, down, sad or depressed a lot? 2. Do you ever think it would just be easier to die? 3. Do you ever hurt yourself on purpose? 4. Have you ever thought about killing yourself? 5. Have you ever tried to kill yourself? Regression analysis was conducted to analyze outcomes by group assignment, race and age.

Demographics (N = 294) Characteristic (Percent) (Count) % African-American 76.2 (224) % Latina 23.8 (70) Age (years)* 16.2 (1.4) Primigravadas 272 (92.5) Prenatal appointments* 10 (4.0) <15 years-old 84 (28.6) >15 years-old 210 (71.4) *Mean/SD

Depression Prevalence (N=294) N Percent Any Depression 81 27.6 Depression Only 49 16.7 Depression SI/SIA 32 10.9 Any Depression by race %African American 60 27 %Latina 21 30 Any Depression by age <age 15 years 25 30 >age 15 years 56 27

Birth Outcomes (N=294) Min. Max. Mean SD Gestational Age(wks) 27 43 39 2 Birth Weight (gms) 964 4318 3081 544 Prenatal Appt 1 20 10 4

Mean Difference in Birth Weight by Depression Symptoms (N=294) Group Comparison Grams 95% CI Sig. Depression vs. Control 42.3 -68.8 to 153.4 NS Low Risk vs. Control 135.2 0.82 to 269.6 p<.05 High Risk vs. Control -105.4 -267.4 to 56.5 NS High Risk vs. Low Risk -234.1 -423.2 to -45.0 p<.05 *Adjusted for age, prenatal appointment and gestational age

Results and Clinical Implications Pregnant teens at greater risk for depression than adult pregnant women (27% vs. 20%). Infants born to mothers with more severe depression are at risk for lower birth weights compared to their low depressed peers (2927 + 466 vs. 3236 + 487 gms). Pregnant teens should be routinely screened for depression and other mental health disorders.