Longitudinal analyses of depressive symptoms across pregnancy in Black women.

PURPOSE: Understanding how depressive symptoms change across pregnancy has been little studied with most research to date relying on a single time point and cohorts of predominately white women. Our objective was to describe the trajectory of depressive symptoms across pregnancy in a sample of Black women, and to identify factors that influence this trajectory.

METHODS

Secondary data analysis of Black pregnant women (N = 1075) in a prospective cohort from three U.S. metropolitan areas. Participants completed questionnaires including the Center for Epidemiological Studies Depression scale (CES-D) at up to three timepoints during pregnancy (8-18 weeks, 22-29 weeks, and 30-36 weeks). Generalized linear mixed modeling was employed for analysis.

RESULTS

CES-D scores decreased across pregnancy for women with scores suggesting severe depressive symptoms (≥23) at baseline. Women who drank alcohol prior to pregnancy had higher scores at baseline. CES-D scores decreased across pregnancy for women who drank alcohol prior to pregnancy and did not change for women with no history of alcohol use prior to pregnancy, suggesting effect modification (interaction p = 0.002).

CONCLUSIONS

Depressive symptoms improved as pregnancy progressed for Black women with severe depressive symptoms at baseline. Alcohol use prior to pregnancy affected the trajectory of depressive symptoms during pregnancy.