The association of stillbirth with depressive symptoms 6-36 months post-delivery

Carol J R Hogue, Corette B. Parker, Marian Willinger, Jeffrey Temple, Carla M. Bann, Robert M. Silver, Donald J. Dudley, Janet L. Moore, Donald R. Coustan, Barbara J. Stoll, Uma M. Reddy, Michael W. Varner, George Saade, Deborah Conway, Robert L. Goldenberg

Research output: Contribution to journalArticle

13 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)131-143
Number of pages13
JournalPaediatric and Perinatal Epidemiology
Volume29
Issue number2
DOIs
StatePublished - Mar 1 2015

Fingerprint

Stillbirth
Depression
Confidence Intervals
Pregnancy
Grief
Selection Bias
Structural Models
Women's Health
Research
Case-Control Studies
Referral and Consultation
Parents
Logistic Models
Odds Ratio
Delivery of Health Care

Keywords

  • African Americans
  • depression
  • follow-up studies
  • grief
  • Stillbirth

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health

Cite this

Hogue, C. J. R., Parker, C. B., Willinger, M., Temple, J., Bann, C. M., Silver, R. M., ... Goldenberg, R. L. (2015). The association of stillbirth with depressive symptoms 6-36 months post-delivery. Paediatric and Perinatal Epidemiology, 29(2), 131-143. https://doi.org/10.1111/ppe.12176

The association of stillbirth with depressive symptoms 6-36 months post-delivery. / Hogue, Carol J R; Parker, Corette B.; Willinger, Marian; Temple, Jeffrey; Bann, Carla M.; Silver, Robert M.; Dudley, Donald J.; Moore, Janet L.; Coustan, Donald R.; Stoll, Barbara J.; Reddy, Uma M.; Varner, Michael W.; Saade, George; Conway, Deborah; Goldenberg, Robert L.

In: Paediatric and Perinatal Epidemiology, Vol. 29, No. 2, 01.03.2015, p. 131-143.

Research output: Contribution to journalArticle

Hogue, CJR, Parker, CB, Willinger, M, Temple, J, Bann, CM, Silver, RM, Dudley, DJ, Moore, JL, Coustan, DR, Stoll, BJ, Reddy, UM, Varner, MW, Saade, G, Conway, D & Goldenberg, RL 2015, 'The association of stillbirth with depressive symptoms 6-36 months post-delivery', Paediatric and Perinatal Epidemiology, vol. 29, no. 2, pp. 131-143. https://doi.org/10.1111/ppe.12176
Hogue, Carol J R ; Parker, Corette B. ; Willinger, Marian ; Temple, Jeffrey ; Bann, Carla M. ; Silver, Robert M. ; Dudley, Donald J. ; Moore, Janet L. ; Coustan, Donald R. ; Stoll, Barbara J. ; Reddy, Uma M. ; Varner, Michael W. ; Saade, George ; Conway, Deborah ; Goldenberg, Robert L. / The association of stillbirth with depressive symptoms 6-36 months post-delivery. In: Paediatric and Perinatal Epidemiology. 2015 ; Vol. 29, No. 2. pp. 131-143.
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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.",
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N2 - 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.

AB - 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.

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