Major and minor depression in pregnancy

OBJECTIVE: To evaluate the time to onset, duration, and risk factors for major and minor depression in pregnant women attending the Centers for Prenatal Care. METHODS: The presence of depressive symptoms and their severity were evaluated at monthly intervals in 154 pregnant women, using the Primary Care Evaluation of Mental Disorders and the Hospital Anxiety and Depression Scale. Comparisons between women with major and minor depression and nondepressed women were performed using the one-way analysis of variance with Bonferroni post-hoc analysis for continuous variables and with Fisher exact test for categorical variables. RESULTS: Major depression was diagnosed in 19 women (12.3%) and minor depression in 28 (18.1%), whereas the remaining 107 did not show any depressive symptoms. Depression was later in onset and had a longer duration in women with major depression (mean +/- standard deviation 5.6 +/- 2.8 months and 2.3 +/- 1.7 months, respectively) than in women with minor depression (3.5 +/- 2.2 months and 1.6 +/- 0.7, respectively; P=.007 and P=.04). The risk of developing major depression was predicted at the beginning of pregnancy by the presence of previous depressive episodes (odds ratio [OR] 9.5, 95% confidence interval [CI] 2.5-29.2) and conflicts with husband/partner (OR 7.8, 95% Cl 1.02-62.7), whereas the risk of developing minor depression was predicted by being a housewife (OR 7.2, 95% Cl 2.3-22.1), presence of previous depressive episodes (OR 4.7, 95% Cl 1.4-15.3) and whether the pregnancy was unwanted (OR 2.4, 95% Cl 1.0-5.7). CONCLUSION: Our study confirms that major and minor depression frequently affect pregnant women, particularly those with a history of depression, and they have different risk factors and onset and duration times. In most women, these disorders are present in a mild form (short duration and mild severity). (Obstet Gynecol 2009;113:1292-8)