Self-reported depression and negative pregnancy outcomes.

Studies addressing the association of depressive symptoms late in pregnancy with pregnancy outcome are lacking. We administered the revised Beck Depression Inventory (BDI) in the third trimester to 323 inner-city adolescents and 389 adults, who were mostly from U.S. minority groups (28.7% Puerto Rican, 61.8% black, 9.6% white). The BDI total score was regressed (as a continuous variable) on indicators of poor pregnancy outcome. There was no relationship of BDI scores with pregnancy outcome in the adolescents. However, among the adult gravidas the risk of a poor outcome rose 5-7% (p < 0.05) for each point the BDI total score increased. For the adults, at a cut-off score of 21 for the BDI, suggestive of clinical depression, the risk of delivering a low birth weight infant of < 2500 g was 3.97 (95% confidence interval [CI] 3.80-4.15); the risk for having a preterm delivery at < 37 completed weeks' gestation was 3.39 (95% CI 3.24-3.56); and their risk of having a small-for-gestational-age infant at < 10th percentile for standards was 3.02 (95% CI 2.88-3.17). Future research should address the physiological mechanisms associated with symptoms of depression that might contribute to an increased risk of poor outcomes and extend the findings to gravidas from different socioeconomic strata.