Predictors of Depression in a High-Risk Hospitalized Pregnancy Population: A Prospective Longitudinal Study




Miltenberger, Paula Dianne

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Research is beginning to elucidate the prevalence and effects of antenatal depression on the mother and fetus. However, relatively little focus has been paid to the woman diagnosed with a high-risk pregnancy requiring hospitalization. The present study investigated the predictors and trajectory of depression in women hospitalized on an antepartum unit. The sample consisted of 129 who were hospitalized due to complications during pregnancy. At admission, the women completed self-report measures to assess depressive symptoms, life events as well as personality. Women who exceeded set thresholds on depressive measures were administered a structural clinical interview to assess for a formal diagnosis of Major Depressive Disorder. Additionally, women's depressive symptoms were assessed weekly across hospitalization until discharge. Forty-four percent of the sample exceeded set threshold at admission, indicating they were experiencing high levels of depressive symptoms. Logistic regression was used to determine predictors of group status at admission, based on depressive measures. Results indicated that only life events were predictive of those women exceeding set thresholds. Furthermore, consideration of pregnancy termination and prior psychiatric diagnosis were predictive of Major Depressive Disorder. Growth curve modeling was used to identify trajectory and changes in depressive symptoms over the course of hospitalization. The results indicated that most women experienced a decrease in symptoms over time. In measuring personality, the Depressive Experiences Questionnaire (Blatt, D'Affliti, & Quinlan, 1976) was used to determine if women characterized as self-critical would report more depression during pregnancy than women characterized as dependent. No significant differences were found between the personality scales and depression severity. However, those women who were high on both self-criticism and dependency had the highest scores on the depressive measures. These results suggests that women who score high on both self-criticism and dependency scales appear to be the most vulnerable to depressive symptoms during the antepartum period.

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