Depressive Symptoms and Health-Related Quality of Life in... : Obstetrics & Gynecology (original) (raw)
Original Research: Lead Article
Nicholson, Wanda K. MD, MPH; Setse, Rosanna MD, MPH; Hill-Briggs, Felicia PhD; Cooper, Lisa A. MD, MPH; Strobino, Donna PhD; Powe, Neil R. MD, MPH
From the 1Department of Gynecology and Obstetrics, Division of General Internal Medicine, 2Department of Medicine, and the 3Welch Center for Prevention, Epidemiology, and Clinical Research, the Johns Hopkins School of Medicine; the 4Women's and Children's Health Policy Center, Department of Population and Family Health Sciences, and the 5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Dr. Nicholson is supported in part by the American Gynecological and Obstetrical Society and the National Institute of Diabetes and Digestive and Kidney Diseases (1K23 DK 067944-01).
The authors thank Lin Zhang, PhD, for statistical advice and Ms. Ruby Grogran for recruiting participants.
Corresponding author: Wanda Nicholson, MD, MPH, Department of Gynecology and Obstetrics, the Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 247, Baltimore, MD 21287; e-mail: [email protected].
OBJECTIVE:
Depressive symptoms can be associated with lower health-related quality of life in late pregnancy. Few studies have quantified the effect of depressive symptoms in early pregnancy or among a racially and economically diverse group. Our goal was to estimate the independent association of depressive symptoms with health-related quality of life among a diverse group of women in early pregnancy.
METHODS:
We conducted a cross-sectional study of 175 pregnant women receiving prenatal care in a community and university-based setting. We related the presence of depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale score of 16 or more to health-related quality of life scores from the 8 Medical Outcomes Study Short Form domains: Physical Functioning, Role-Physical, Bodily Pain, Vitality, General Health, Social Functioning, Role-Emotional, and Mental Health. Quantile regression was used to measure the independent association of depressive symptoms with each of the 8 domains.
RESULTS:
The study sample was 49% African American, 38% white, and 11% Asian. Mean (± standard deviation) gestational age was 14 ± 6 weeks.The prevalence of depressive symptoms was 15%. Women with depressive symptoms had significantly lower health-related quality of life scores in all domains except Physical Functioning. After adjustment for sociodemographic, clinical, and social support factors, depressive symptoms were associated with health-related quality of life scores that were 30 points lower in Role-Physical, 19 points lower in Bodily Pain, 10 points lower in General Health, and 56 points lower in Role-Emotional.
CONCLUSION:
Women in early pregnancy with depressive symptoms have poor health-related quality of life. Early identification and management of depressive symptoms in pregnant women may improve their sense of well-being.
LEVEL OF EVIDENCE:
II-2
© 2006 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.