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01-10-2012

Preconception Mental Health Predicts Pregnancy Complications and Adverse Birth Outcomes: A National Population-Based Study

Authors: Whitney P. Witt, Lauren E. Wisk, Erika R. Cheng, John M. Hampton, Erika W. Hagen

Published in: Maternal and Child Health Journal | Issue 7/2012

Abstract

Pregnancy complications and poor birth outcomes can affect the survival and long-term health of children. The preconception period represents an opportunity to intervene and improve outcomes; however little is known about women’s mental health prior to pregnancy as a predictor of such outcomes. We sought to determine if and to what extent women’s preconception mental health status impacted subsequent pregnancy complications, non-live birth, and birth weight using a nationally representative, population-based sample. We used pooled 1996–2006 data from the nationally-representative Medical Expenditure Panel Survey (MEPS). Poor preconception mental health was defined as women’s global mental health rating of “fair” or “poor” before conception. Logistic regression was used to assess the association between preconception mental health and pregnancy complications, non-live birth, and having a low birth weight baby within the follow up period. Poor preconception mental health was associated with increased odds of experiencing any pregnancy complication (AOR 1.40, 95% CI: 1.02–1.92), having a non-live birth (AOR 1.48, 95% CI: 0.96–2.27), and having a low birth weight baby (AOR 1.99, 95% CI: 1.00–3.98), all controlling for maternal age, race/ethnicity, marital status, education, health insurance status, income, and number of children in the household. Significant racial and ethnic disparities exist for pregnancy complications and non-live births, but not for low birth weight. Women’s preconception mental health is a modifiable risk factor that stands to reduce the incidence of adverse pregnancy complications and birth outcomes.

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Xu, J., Kochanek, K., Murphy, S., & Tejada-Vera, B. (2010). Deaths: Final data for 2007. National vital statistics reports (Vol. 58, pp. 1–135). Maryland: Hyattsville.

Bhushan, V., Paneth, N., & Kiely, J. L. (1993). Impact of improved survival of very low birth weight infants on recent secular trends in the prevalence of cerebral palsy. Pediatrics, 91, 1094–1100.PubMed

McCormick, M. C. (1985). The contribution of low birth weight to infant mortality and childhood morbidity. The New England Journal of Medicine, 312, 82–90.PubMedCrossRef

Atrash, H. K., Johnson, K., Adams, M., Cordero, J. F., & Howse, J. (2006). Preconception care for improving perinatal outcomes: The time to act. Maternal and Child Health Journal, 10, S3–S11.PubMedCrossRef

Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67, 1012–1024.PubMedCrossRef

Alder, J., Fink, N., Bitzer, J., Hosli, I., & Holzgreve, W. (2007). Depression and anxiety during pregnancy: A risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. The Journal of Maternal-Fetal & Neonatal Medicine, 20, 189–209.CrossRef

Precht, D. H., Andersen, P. K., & Olsen, J. (2007). Severe life events and impaired fetal growth: A nation-wide study with complete follow-up. Acta Obstetricia et Gynecologica Scandinavica, 86, 266–275.PubMedCrossRef

Sjostrom, K., Thelin, T., Valentin, L., & Marsal, K. (1999). Do pre-, early, and mid-pregnancy life events influence gestational length? Journal of Psychosomatic Obstetrics and Gynaecology, 20, 170–176.PubMedCrossRef

Khashan, A. S., McNamee, R., Abel, K. M., et al. (2009). Rates of preterm birth following antenatal maternal exposure to severe life events: A population-based cohort study. Human Reproduction, 24, 429–437.PubMedCrossRef

10.

Khashan, A. S., McNamee, R., Abel, K. M., et al. (2008). Reduced infant birthweight consequent upon maternal exposure to severe life events. Psychosomatic Medicine, 70, 688–694.PubMedCrossRef

11.

Gavin, A. R., Chae, D. H., Mustillo, S., & Kiefe, C. I. (2009). Prepregnancy depressive mood and preterm birth in black and white women: Findings from the CARDIA study. Journal of Women’s Health (Larchmt), 18, 803–811.CrossRef

12.

Gold, K. J., Dalton, V. K., Schwenk, T. L., & Hayward, R. A. (2007). What causes pregnancy loss? Preexisting mental illness as an independent risk factor. General Hospital Psychiatry, 29, 207–213.PubMedCrossRef

13.

Haas, J. S., Fuentes-Afflick, E., Stewart, A. L., et al. (2005). Prepregnancy health status and the risk of preterm delivery. Archives of Pediatrics and Adolescent Medicine, 159, 58–63.PubMedCrossRef

14.

Mustillo, S., Krieger, N., Gunderson, E. P., Sidney, S., McCreath, H., & Kiefe, C. I. (2004). Self-reported experiences of racial discrimination and Black-White differences in preterm and low-birthweight deliveries: The CARDIA study. American Journal of Public Health, 94, 2125–2131.PubMedCrossRef

15.

Misra, D. P., Guyer, B., & Allston, A. (2003). Integrated perinatal health framework. A multiple determinants model with a life span approach. American Journal of Preventive Medicine, 25, 65–75.PubMedCrossRef

16.

Halfon, N., & Hochstein, M. (2002). Life course health development: An integrated framework for developing health, policy, and research. The Milbank Quarterly, 80, 433–479.PubMedCrossRef

17.

Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7, 13–30.PubMedCrossRef

18.

Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science and Medicine, 31, 1347–1363.PubMedCrossRef

19.

Committee on Scientific Evaluation of WIC Nutrition Risk Criteria, Institute of Medicine (1996) WIC nutrition risk criteria: A scientific assessment. Washington, D.C.: National Academy Press.

20.

Mawani, F. N., & Gilmour, H. (2010). Validation of self-rated mental health. Health Reports, 21, 61–75.PubMed

21.

Fleishman, J. A., & Zuvekas, S. H. (2007). Global self-rated mental health: Associations with other mental health measures and with role functioning. Medical Care, 45, 602–609.PubMedCrossRef

22.

Cohen, J. W., Monheit, A. C., Beauregard, K. M., et al. (1997). The medical expenditure panel survey: A national health information resource. Inquiry, 33, 373.

23.

Bryant, A. S., Worjoloh, A., Caughey, A. B., & Washington, A. E. (2010). Racial/ethnic disparities in obstetric outcomes and care: Prevalence and determinants. American Journal of Obstetrics and Gynecology, 202, 335–343.PubMedCrossRef

24.

van Oppenraaij, R. H., Jauniaux, E., Christiansen, O. B., Horcajadas, J. A., Farquharson, R. G., & Exalto, N. (2009). Predicting adverse obstetric outcome after early pregnancy events and complications: A review. Human Reproduction Update, 15, 409–421.PubMedCrossRef

25.

Villar, J., Farnot, U., Barros, F., Victora, C., Langer, A., & Belizan, J. M. (1992). A randomized trial of psychosocial support during high-risk pregnancies. The Latin American Network for Perinatal and Reproductive Research. The New England Journal of Medicine, 327, 1266–1271.PubMedCrossRef

26.

Bryce, R. L., Stanley, F. J., & Garner, J. B. (1991). Randomized controlled trial of antenatal social support to prevent preterm birth. British Journal of Obstetrics and Gynaecology, 98, 1001–1008.PubMedCrossRef

27.

Dunkel Schetter, C. (2011). Psychological science on pregnancy: Stress processes, biopsychosocial models, and emerging research issues. Annual Review of Psychology, 62, 531–558.PubMedCrossRef

28.

Strohle, A., & Holsboer, F. (2003). Stress responsive neurohormones in depression and anxiety. Pharmacopsychiatry, 36, S207–S214.PubMed

29.

Wadhwa, P. D., Culhane, J. F., Rauh, V., et al. (2001). Stress, infection and preterm birth: A biobehavioural perspective. Paediatric and Perinatal Epidemiology, 15, 17–29.PubMedCrossRef

30.

Hobel, C. J., Dunkel-Schetter, C., Roesch, S. C., Castro, L. C., & Arora, C. P. (1999). Maternal plasma corticotropin-releasing hormone associated with stress at 20 weeks’ gestation in pregnancies ending in preterm delivery. American Journal of Obstetrics and Gynecology, 180, S257–S263.PubMedCrossRef

31.

McGrath, S., McLean, M., Smith, D., Bisits, A., Giles, W., & Smith, R. (2002). Maternal plasma corticotropin-releasing hormone trajectories vary depending on the cause of preterm delivery. American Journal of Obstetrics and Gynecology, 186, 257–260.PubMedCrossRef

32.

Pike, I. L. (2005). Maternal stress and fetal responses: Evolutionary perspectives on preterm delivery. American Journal of Human Biology, 17, 55–65.PubMedCrossRef

33.

Diego, M. A., Field, T., Hernandez-Reif, M., Cullen, C., Schanberg, S., & Kuhn, C. (2004). Prepartum, postpartum, and chronic depression effects on newborns. Psychiatry, 67, 63–80.PubMed

34.

Field, T., Diego, M., Dieter, J., et al. (2004). Prenatal depression effects on the fetus and the newborn. Infant Behavior and Development, 27, 216–229.CrossRef

35.

Lundy, B. L., Jones, N. A., Field, T., et al. (1999). Prepartum depression effects on neonates. Infant Behavior and Development, 22, 121–137.CrossRef

36.

Witt, W. P., DeLeire, T., Hagen, E. W., et al. (2010). The prevalence and determinants of antepartum mental health problems among women in the USA: A nationally representative population-based study. Archives of Women’s Mental Health, 13, 425–437.PubMedCrossRef

37.

Witt, W. P., Wisk, L. E., Cheng, E. R., et al. (2011). Poor prepregnancy and antepartum mental health predicts postpartum mental health problems among US women: A nationally representative population-based study. Womens Health Issues, 21, 304–313.PubMedCrossRef

38.

Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women’s Health (Larchmt), 12, 373–380.CrossRef

39.

Witt, W. P., Keller, A., Gottlieb, C., et al. (2009). Access to adequate outpatient depression care for mothers in the USA: A nationally representative population-based study. The Journal of Behavioral Health Services & Research, 38, 191–204.CrossRef

40.

Atrash, H., Jack, B. W., & Johnson, K. (2008). Preconception care: A 2008 update. Current Opinion in Obstetrics and Gynecology, 20, 581–589.PubMedCrossRef

41.

D’Angelo, D., Williams, L., Morrow, B., et al. (2007). Preconception and interconception health status of women who recently gave birth to a live-born infant—Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 reporting areas, 2004. MMWR Surveillance Summaries, 56, 1–35.

42.

Kirkham, C., Harris, S., & Grzybowski, S. (2005). Evidence-based prenatal care: Part I. General prenatal care and counseling issues. American Family Physician, 71, 1307–1316.PubMed

43.

Javert, C. T. (1958). Prevention of habitual spontaneous abortion with early prenatal care. Bulletin of the New York Academy of Medicine, 34, 747–756.PubMed

44.

Katz, V. (2007). Spontaneous and recurrent abortion: Etiology, diagnosis, treatment. In V. Katz, G. Lentz, R. Lobo, & D. Gershenson (Eds.), Comprehensive gynecology (pp. 359–388). Philadelphia: Mosby Elsevier.CrossRef

45.

Baird, D. T., Cnattingius, S., Collins, J., et al. (2006). Nutrition and reproduction in women. Human Reproduction Update, 12, 193–207.CrossRef

46.

Ness, R. B., Grisso, J. A., Hirschinger, N., et al. (1999). Cocaine and tobacco use and the risk of spontaneous abortion. The New England Journal of Medicine, 340, 333–339.PubMedCrossRef

47.

Baraban, E., McCoy, L., & Simon, P. (2008). Increasing prevalence of gestational diabetes and pregnancy-related hypertension in Los Angeles County, California, 1991–2003. Preventing Chronic Disease, 5, A77.PubMed

48.

Caughey, A. B., Stotland, N. E., Washington, A. E., & Escobar, G. J. (2005). Maternal ethnicity, paternal ethnicity, and parental ethnic discordance: Predictors of preeclampsia. Obstetrics and Gynecology, 106, 156–161.PubMedCrossRef

49.

Thorpe, L. E., Berger, D., Ellis, J. A., et al. (2005). Trends and racial/ethnic disparities in gestational diabetes among pregnant women in New York City, 1990–2001. American Journal of Public Health, 95, 1536–1539.PubMedCrossRef

50.

Healy, A. J., Malone, F. D., Sullivan, L. M., et al. (2006). Early access to prenatal care: Implications for racial disparity in perinatal mortality. Obstetrics and Gynecology, 107, 625–631.PubMedCrossRef

51.

Fiscella, K. (1996). Race, perinatal outcome, and amniotic infection. Obstetrical and Gynecological Survey, 51, 60–66.PubMedCrossRef

52.

Anum, E. A., Brown, H. L., & Strauss, J. F., 3rd. (2010). Health disparities in risk for cervical insufficiency. Human Reproduction, 25, 2894–2900.PubMedCrossRef

53.

Hulsey, T. C., Levkoff, A. H., Alexander, G. R., & Tompkins, M. (1991). Differences in black and white infant birth weights: The role of maternal demographic factors and medical complications of pregnancy. Southern Medical Journal, 84, 443–446.PubMedCrossRef

54.

Alexander, G. R., Kogan, M. D., Himes, J. H., Mor, J. M., & Goldenberg, R. (1999). Racial differences in birthweight for gestational age and infant mortality in extremely-low-risk US populations. Paediatric and Perinatal Epidemiology, 13, 205–217.PubMedCrossRef

55.

Lu, M. C., & Chen, B. (2004). Racial and ethnic disparities in preterm birth: The role of stressful life events. American Journal of Obstetrics and Gynecology, 191, 691–699.PubMedCrossRef

56.

Berg, C. J., Wilcox, L. S., & d’Almada, P. J. (2001). The prevalence of socioeconomic and behavioral characteristics and their impact on very low birth weight in black and white infants in Georgia. Maternal and Child Health Journal, 5, 75–84.PubMedCrossRef

57.

Hessol, N. A., Fuentes-Afflick, E., & Bacchetti, P. (1998). Risk of low birth weight infants among black and white parents. Obstetrics and Gynecology, 92, 814–822.PubMedCrossRef

58.

Luo, Z. C., Wilkins, R., & Kramer, M. S. (2004). Disparities in pregnancy outcomes according to marital and cohabitation status. Obstetrics and Gynecology, 103, 1300–1307.PubMedCrossRef

59.

Hein, H. A., Burmeister, L. F., & Papke, K. R. (1990). The relationship of unwed status to infant mortality. Obstetrics and Gynecology, 76, 763–768.PubMedCrossRef

60.

Abel, M. H. (1997). Low birth weight and interactions between traditional risk factors. The Journal of Genetic Psychology, 158, 443–456.PubMedCrossRef

61.

Rantakallio, P., & Oja, H. (1990). Perinatal risk for infants of unmarried mothers over a period of 20 years. Early Human Development, 22, 157–169.PubMedCrossRef

62.

Bruckner, T. A., Saxton, K. B., Anderson, E., Goldman, S., & Gould, J. B. (2009). From paradox to disparity: Trends in neonatal death in very low birth weight non-Hispanic black and white infants, 1989–2004. Journal of Pediatrics, 155, 482–487.PubMedCrossRef

63.

Collins, J. W., Jr., David, R. J., Simon, D. M., & Prachand, N. G. (2007). Preterm birth among African American and white women with a lifelong residence in high-income Chicago neighborhoods: An exploratory study. Ethnicity and Disease, 17, 113–117.PubMed

64.

Rutter, D. R., & Quine, L. (1990). Inequalities in pregnancy outcome: A review of psychosocial and behavioural mediators. Social Science and Medicine, 30, 553–568.PubMedCrossRef

65.

Kalinka, J., Laudanski, T., Hanke, W., & Wasiela, M. (2003). Do microbiological factors account for poor pregnancy outcome among unmarried pregnant women in Poland? Fetal Diagnosis and Therapy, 18, 345–352.PubMedCrossRef

66.

Kandel, D. B., Griesler, P. C., & Schaffran, C. (2009). Educational attainment and smoking among women: Risk factors and consequences for offspring. Drug and Alcohol Dependence, 104, S24–S33.PubMedCrossRef

67.

Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. American Journal of Preventive Medicine, 39, 263–272.PubMedCrossRef

68.

Bramness, J. G., Walby, F. A., Hjellvik, V., Selmer, R., & Tverdal, A. (2010). Self-reported mental health and its gender differences as a predictor of suicide in the middle-aged. American Journal of Epidemiology, 172, 160.PubMedCrossRef

69.

Ananth, C. V., Peltier, M. R., Chavez, M. R., Kirby, R. S., Getahun, D., & Vintzileos, A. M. (2007). Recurrence of ischemic placental disease. Obstetrics and Gynecology, 110, 128.PubMedCrossRef

Title: Preconception Mental Health Predicts Pregnancy Complications and Adverse Birth Outcomes: A National Population-Based Study
Authors: Whitney P. Witt
Lauren E. Wisk
Erika R. Cheng
John M. Hampton
Erika W. Hagen
Publication date: 01-10-2012
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 7/2012
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-011-0916-4

At a glance: The STEP trials

Springer Medicine

Preconception Mental Health Predicts Pregnancy Complications and Adverse Birth Outcomes: A National Population-Based Study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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