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Objective: Depressive symptoms are known to affect functioning in early pregnancy. We estimated the effect of a change in depressive symptoms status on health-related quality of life (HRQoL) throughout pregnancy and after delivery., Methods: Longitudinal study of 200 women. The independent variable was depressive symptoms, defined as a Center for Epidemiologic Studies Depression (CES-D) score of > or =16. The dependent variable was HRQoL from 8 domains of the Medical Outcomes Study (SF-36) Short Form. Women were categorized based on the change in CES-D score: (1) never depressed, (2) became well, (3) became depressed and (4) always depressed. A random effects model was used to (1) estimate the effect of a change in depressive symptomatology from the first to the second trimester on HRQOL in the second trimester and (2) estimate the change in depressive symptomatology from the second to the third trimester on HRQoL in the third trimester and after delivery, adjusting for covariates. Intra-individual correlations were accounted for using generalized estimating equations (GEE)., Results: The proportion of women with depressive symptoms was 15%, 14%, and 30% in the first, second and third trimesters, respectively, and 9% after delivery. Women who became depressed had scores in the social domains that were 10-23 points and 19-31 points lower in the second and third trimesters, respectively, compared to women with no depressive symptoms. Women who became well had scores that were 3-31 points lower, compared to women with no depressive symptoms., Conclusions: Alterations in depressive symptomatology have a substantial effect on functioning during pregnancy and after delivery. more...

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. more...