Unplanned pregnancy and risk of maternal depression: secondary data analysis from a prospective pregnancy cohort

Abstract

Purpose: to evaluate the relationship between unplanned pregnancy (UP), a common problem in high and low income countries and maternal depression (MD). Methods: Secondary analysis of data from a prospective cohort study with pregnant women recruited from 10 primary care clinics of the public sector in São Paulo, Brazil. Participants were questioned about pregnancy intention at 20–30 weeks of gestation. The Self Report Questionnaire score >7 was used to evaluated the presence of depression during pregnancy and 11 months after childbirth. Four groups of MD were defined: never; antenatal only; postnatal only; persistent (both antenatal/postnatal). Multinomial logistic regression was used to assess the relationship between UP and MD, controlling for confounding. Results: Data were analysed for 701 at the postpartum period. Five hundred and sixty-two (67.8%) women did not plan the pregnancy. Women with UP had 2.5 more risk of being depressed during both assessments (during pregnancy and postpartum) when compared to women with a planned pregnancy (RR: 2.5; 95% CI: 1.47:4.30). In the adjusted models, women with UP were significantly more likely to have persistent depression (RR: 2.3; 95% CI: 1.2:4.3). Conclusion: UP is an independent risk factor for persistent depression, but not for postpartum depression

Keywords:

• Pregnancy intention
• unplanned pregnancy
• postpartum depression
• perinatal depression

Funding

The study was funded by FAPESP [2003/08553-7]. Paulo Rossi Menezes was partly funded by the CNPq-Brazil. Alexandre Faisal-Cury received postdoctoral fellowships from the CNPq-Brazil and FAPESP