Objective: to investigate the relationship between physical health problems and depressive symptoms in early pregnancy.
Design: baseline questionnaire, prospective pregnancy cohort study.
Setting: six metropolitan public maternity hospitals in Victoria, Australia.
Participants: 1507 nulliparous women recruited in early pregnancy.
Findings: nine per cent of women (131/1500) scored ≥ 13 on the EPDS indicating probable clinical depression in early pregnancy (mean gestation=15 weeks). The five most commonly reported physical health problems were as follows: exhaustion (86.9%), morning sickness (64.3%), back pain (45.6%), constipation (43.5%) and severe headaches or migraines (29.5%). Women scoring ≥ 13 on the EPDS reported a mean of six physical health problems compared with a mean of 3.5 among women scoring <13 on the EPDS. Women reporting five or more physical health problems had a three-fold increase in likelihood of reporting depressive symptoms (Adj OR=3.13, 95% CI 2.14-4.58) after adjusting for socio-demographic factors, including maternal age.
Conclusions: the findings from this large multi-centre study show that women experiencing a greater number of physical health problems are at increased risk of reporting depressive symptoms in early pregnancy.
Implications for practice: early detection and support for women experiencing physical and psychological health problems in pregnancy is an important aspect of antenatal care. The extent of co-morbid physical and psychological health problems underlines the need for comprehensive primary health care as an integral component of antenatal care.
Copyright © 2012 Elsevier Ltd. All rights reserved.