Pregnant women with symptoms of depression are twice as likely to deliver their babies early as those who don't show signs of sadness, new research shows.
The findings reflect two troubling trends: preterm delivery is the leading cause of infant illness and death in the U.S., and more than 40 percent of pregnant women report depressive symptoms, according to the study in today's Human Reproduction.

“It’s a severely under-diagnosed area frequently being dismissed just as having the blues of being pregnant,” says study author De-Kun Li, a reproductive and perinatal epidemiologist in the division of research at Kaiser Permanente, a nationwide health insurer. “If just by controlling depression we can reduce preterm delivery, that will be very significant.”

Kaiser scientists asked 791 pregnant women if they had suffered symptoms of depression during their first trimester. Of the 40 percent who said they had, 9 percent with severe symptoms and 6 percent with mild signs gave birth prematurely. Just 4 percent of those reporting no such symptoms delivered early.

Scientists disagree over the safety of taking antidepressants during pregnancy; just 1.5 percent of the women in the new study were using the drugs to control their blues – too few to determine whether the meds affected their deliveries, Li says. Other research has shown an increase in early deliveries among women taking antidepressants, but it’s unclear whether the medications themselves or the underlying depression were the cause. There is some evidence that the meds increase the risk of low birth weight; a 1999 review found no higher risk of birth defects or behavioral problems in children born to women who took the drugs, but more recent studies have found some rare heart defects.

“Depression during pregnancy needs to be paid attention to and brought to the forefront of prenatal care,” Li says, “but the treatment doesn’t have to be medication. The safety of antidepressants during pregnancy is still an unsettled question. For minor [depression], all they probably need is to be getting emotional and physical support from their spouse and family.”

(Image by iStockphoto/Sharon Dominick)