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Obstetrics
Maternal depressive symptoms, serum folate status, and pregnancy outcome: results of the Amsterdam Born Children and their Development study

Presented at the 6th World Conference on Developmental Origins of Health and Disease, Santiago, Chile, Nov. 19-22, 2009.
https://doi.org/10.1016/j.ajog.2010.07.017Get rights and content

Objective

The objective was to explore whether different levels of depressive symptoms in pregnant women and their serum folate status combined were associated with the gestational age and birthweight of their offspring.

Study Design

Data were derived from pregnant women in Amsterdam who completed a questionnaire covering depressive symptoms (Center for Epidemiological Studies Depression Scale) and from whom blood samples were taken to determine serum folate status. Only live-born singletons were included (n = 4044) in the multivariate regression analysis.

Results

When adjusted for potential confounders, only the association between major depressive symptoms and gestational age remained significant (–0.2 weeks; 95% confidence interval, –0.4 to –0.1). Women with depressive symptoms and low folate status (7.6%) experienced the shortest gestational age (38.6 weeks) and lowest birthweight (3270 g) (there was no significant interaction).

Conclusion

Depressive symptoms were associated with shorter gestational age and related lower birthweight. The study results underline the importance of folic acid intake specifically in women suffering from depressive symptoms.

Section snippets

Materials and Methods

The present study is part of the Amsterdam Born Children and their Development (ABCD) study. The ABCD study is a prospective birth cohort study examining the associations between pregnancy conditions and the child's health in a multiethnic population (www.abcd-study.nl). Pregnant women from Amsterdam were approached for their participation between January 2003 and March 2004 when they first visited an obstetric care provider. All (12,373) received a questionnaire by post, which was filled out

Results

Following the inclusion criteria, 4044 cases were included in the current study's analyses. In this sample, the first visit to an obstetric care provider and thus determination of serum folate status was around the 14th (IQR, 12th to 15th) week of pregnancy. Population characteristics are presented by depressive symptoms group in Table 1.

The folate status quintiles as used in the analyses were defined by folate status standardized for pregnancy duration at the time of blood collection. The

Comment

In this large population-based cohort, depressive symptoms were associated with shorter gestational age and related lower birthweight. The combination of depressive symptoms and low serum folate status (present in 7.6% of the pregnant women) was associated with a shorter gestation of 2.8 days on average, but there was no significant interaction. The onset of delivery did not influence the results.

To our knowledge, the current study is the first to explore the combined detrimental effect of

Acknowledgments

We kindly thank all participants of the ABCD cohort and their obstetric care providers.

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    This study was supported in part by The Netherlands Organization for Health Research and Development (ZonMw) and The Netherlands Heart Foundation.

    Cite this article as: van Dijk AE, van Eijsden M, Stronks K, et al. Maternal depressive symptoms, serum folate status, and pregnancy outcome: results of the Amsterdam Born Children and their Development study. Am J Obstet Gynecol 2010;203:563.e1-7.

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