PURPOSE: To examine the association between prepregnancy depressive symptoms and preterm birth. METHODS: The present study is a prospective investigation of prepregnancy depressive symptoms-measured by the Center for Epidemiologic Studies Depression Scale (CES-D)-and risk of preterm birth reported in the Black Women's Health Study. With data on 2,627 singleton births (175 spontaneous and 163 medically indicated preterm births and 2,289 term births), we used generalized estimating equation models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for potential confounders. RESULTS: Relative to mothers with CES-D scores less than 16, the multivariable ORs of spontaneous preterm birth for mothers with CES-D scores of 16-22, 23-32, and > or =33 were 1.17 (95% CI = 0.78-1.80), 1.20 (95% CI = 0.69-2.10), and 2.00 (95% CI = 0.94-4.25), respectively (p for trend = 0.09). There was little evidence of an association between prepregnancy depressive symptoms and medically indicated preterm birth. CONCLUSIONS: Our data provide some evidence of an increased risk of spontaneous preterm birth among women with high prepregnancy depressive symptoms.
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