Perinatal depressive symptoms in HIV-infected versus HIV-uninfected women: A prospective study from preconception to postpartum

Leah H. Rubin, Judith A. Cook, Dennis D. Grey, Kathleen Weber, Christina Wells, Elizabeth T. Golub, Rodney L. Wright, Rebecca M. Schwartz, Lakshmi Goparaju, Deborah Cohan, Melissa L. Wilson, Pauline M. Maki

Research output: Contribution to journalArticle

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Abstract

Objective: Depression is common among HIV-infected women, predicts treatment nonadherence, and consequently may impact vertical transmission of HIV. We report findings from a study evaluating preconception, pregnancy, and postpartum depressive symptoms in HIV-infected vs. at-risk, HIV-uninfected women. Methods: We examined the prevalence and predictors of elevated perinatal (i.e., pregnancy and/or postpartum) depressive symptoms using a Center for Epidemiological Studies-Depression (CES-D) scale score of ≥16 in 139 HIV-infected and 105 HIV-uninfected women (62% African American) from the Women's Interagency HIV Study (WIHS). Results: The prevalence of elevated perinatal depressive symptoms did not differ by HIV serostatus (HIV-infected 44%, HIV-uninfected 50%, p=0.44). Among HIV-infected women, the strongest predictor of elevated symptoms was preconception depression (odds ratio [OR] 5.71, 95% confidence interval [CI] 2.67-12.19, p<0.001); crack, cocaine, and/or heroin use during preconception was marginally significant (OR 3.10, 95% CI 0.96-10.01, p=0.06). In the overall sample, additional significant predictors of perinatal depression included having multiple sex partners preconception (OR 2.20, 95% CI 1.12-4.32, p=0.02), use of preconception mental health services (OR 2.51, 95% CI 1.03-6.13, p=0.04), and not graduating from high school (OR 1.92, 95% CI 1.06-3.46, p=0.03). Conclusions: Elevated perinatal depressive symptoms are common among HIV-infected and at-risk HIV-uninfected women. Depressive symptoms before pregnancy were the strongest predictor of perinatal symptoms. Findings underscore the importance of early and ongoing assessment and treatment to ensure low vertical transmission rates and improving postpregnancy outcomes for mothers and children.

Original languageEnglish (US)
Pages (from-to)1287-1295
Number of pages9
JournalJournal of Women's Health
Volume20
Issue number9
DOIs
StatePublished - Sep 1 2011

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Postpartum Period
HIV
Prospective Studies
Depression
Odds Ratio
Confidence Intervals
Pregnancy
Crack Cocaine
Sexual Partners
Heroin
Mental Health Services
African Americans
Epidemiologic Studies
Mothers

ASJC Scopus subject areas

  • Medicine(all)

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Perinatal depressive symptoms in HIV-infected versus HIV-uninfected women : A prospective study from preconception to postpartum. / Rubin, Leah H.; Cook, Judith A.; Grey, Dennis D.; Weber, Kathleen; Wells, Christina; Golub, Elizabeth T.; Wright, Rodney L.; Schwartz, Rebecca M.; Goparaju, Lakshmi; Cohan, Deborah; Wilson, Melissa L.; Maki, Pauline M.

In: Journal of Women's Health, Vol. 20, No. 9, 01.09.2011, p. 1287-1295.

Research output: Contribution to journalArticle

Rubin, LH, Cook, JA, Grey, DD, Weber, K, Wells, C, Golub, ET, Wright, RL, Schwartz, RM, Goparaju, L, Cohan, D, Wilson, ML & Maki, PM 2011, 'Perinatal depressive symptoms in HIV-infected versus HIV-uninfected women: A prospective study from preconception to postpartum', Journal of Women's Health, vol. 20, no. 9, pp. 1287-1295. https://doi.org/10.1089/jwh.2010.2485
Rubin, Leah H. ; Cook, Judith A. ; Grey, Dennis D. ; Weber, Kathleen ; Wells, Christina ; Golub, Elizabeth T. ; Wright, Rodney L. ; Schwartz, Rebecca M. ; Goparaju, Lakshmi ; Cohan, Deborah ; Wilson, Melissa L. ; Maki, Pauline M. / Perinatal depressive symptoms in HIV-infected versus HIV-uninfected women : A prospective study from preconception to postpartum. In: Journal of Women's Health. 2011 ; Vol. 20, No. 9. pp. 1287-1295.
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abstract = "Objective: Depression is common among HIV-infected women, predicts treatment nonadherence, and consequently may impact vertical transmission of HIV. We report findings from a study evaluating preconception, pregnancy, and postpartum depressive symptoms in HIV-infected vs. at-risk, HIV-uninfected women. Methods: We examined the prevalence and predictors of elevated perinatal (i.e., pregnancy and/or postpartum) depressive symptoms using a Center for Epidemiological Studies-Depression (CES-D) scale score of ≥16 in 139 HIV-infected and 105 HIV-uninfected women (62{\%} African American) from the Women's Interagency HIV Study (WIHS). Results: The prevalence of elevated perinatal depressive symptoms did not differ by HIV serostatus (HIV-infected 44{\%}, HIV-uninfected 50{\%}, p=0.44). Among HIV-infected women, the strongest predictor of elevated symptoms was preconception depression (odds ratio [OR] 5.71, 95{\%} confidence interval [CI] 2.67-12.19, p<0.001); crack, cocaine, and/or heroin use during preconception was marginally significant (OR 3.10, 95{\%} CI 0.96-10.01, p=0.06). In the overall sample, additional significant predictors of perinatal depression included having multiple sex partners preconception (OR 2.20, 95{\%} CI 1.12-4.32, p=0.02), use of preconception mental health services (OR 2.51, 95{\%} CI 1.03-6.13, p=0.04), and not graduating from high school (OR 1.92, 95{\%} CI 1.06-3.46, p=0.03). Conclusions: Elevated perinatal depressive symptoms are common among HIV-infected and at-risk HIV-uninfected women. Depressive symptoms before pregnancy were the strongest predictor of perinatal symptoms. Findings underscore the importance of early and ongoing assessment and treatment to ensure low vertical transmission rates and improving postpregnancy outcomes for mothers and children.",
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T2 - A prospective study from preconception to postpartum

AU - Rubin, Leah H.

AU - Cook, Judith A.

AU - Grey, Dennis D.

AU - Weber, Kathleen

AU - Wells, Christina

AU - Golub, Elizabeth T.

AU - Wright, Rodney L.

AU - Schwartz, Rebecca M.

AU - Goparaju, Lakshmi

AU - Cohan, Deborah

AU - Wilson, Melissa L.

AU - Maki, Pauline M.

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N2 - Objective: Depression is common among HIV-infected women, predicts treatment nonadherence, and consequently may impact vertical transmission of HIV. We report findings from a study evaluating preconception, pregnancy, and postpartum depressive symptoms in HIV-infected vs. at-risk, HIV-uninfected women. Methods: We examined the prevalence and predictors of elevated perinatal (i.e., pregnancy and/or postpartum) depressive symptoms using a Center for Epidemiological Studies-Depression (CES-D) scale score of ≥16 in 139 HIV-infected and 105 HIV-uninfected women (62% African American) from the Women's Interagency HIV Study (WIHS). Results: The prevalence of elevated perinatal depressive symptoms did not differ by HIV serostatus (HIV-infected 44%, HIV-uninfected 50%, p=0.44). Among HIV-infected women, the strongest predictor of elevated symptoms was preconception depression (odds ratio [OR] 5.71, 95% confidence interval [CI] 2.67-12.19, p<0.001); crack, cocaine, and/or heroin use during preconception was marginally significant (OR 3.10, 95% CI 0.96-10.01, p=0.06). In the overall sample, additional significant predictors of perinatal depression included having multiple sex partners preconception (OR 2.20, 95% CI 1.12-4.32, p=0.02), use of preconception mental health services (OR 2.51, 95% CI 1.03-6.13, p=0.04), and not graduating from high school (OR 1.92, 95% CI 1.06-3.46, p=0.03). Conclusions: Elevated perinatal depressive symptoms are common among HIV-infected and at-risk HIV-uninfected women. Depressive symptoms before pregnancy were the strongest predictor of perinatal symptoms. Findings underscore the importance of early and ongoing assessment and treatment to ensure low vertical transmission rates and improving postpregnancy outcomes for mothers and children.

AB - Objective: Depression is common among HIV-infected women, predicts treatment nonadherence, and consequently may impact vertical transmission of HIV. We report findings from a study evaluating preconception, pregnancy, and postpartum depressive symptoms in HIV-infected vs. at-risk, HIV-uninfected women. Methods: We examined the prevalence and predictors of elevated perinatal (i.e., pregnancy and/or postpartum) depressive symptoms using a Center for Epidemiological Studies-Depression (CES-D) scale score of ≥16 in 139 HIV-infected and 105 HIV-uninfected women (62% African American) from the Women's Interagency HIV Study (WIHS). Results: The prevalence of elevated perinatal depressive symptoms did not differ by HIV serostatus (HIV-infected 44%, HIV-uninfected 50%, p=0.44). Among HIV-infected women, the strongest predictor of elevated symptoms was preconception depression (odds ratio [OR] 5.71, 95% confidence interval [CI] 2.67-12.19, p<0.001); crack, cocaine, and/or heroin use during preconception was marginally significant (OR 3.10, 95% CI 0.96-10.01, p=0.06). In the overall sample, additional significant predictors of perinatal depression included having multiple sex partners preconception (OR 2.20, 95% CI 1.12-4.32, p=0.02), use of preconception mental health services (OR 2.51, 95% CI 1.03-6.13, p=0.04), and not graduating from high school (OR 1.92, 95% CI 1.06-3.46, p=0.03). Conclusions: Elevated perinatal depressive symptoms are common among HIV-infected and at-risk HIV-uninfected women. Depressive symptoms before pregnancy were the strongest predictor of perinatal symptoms. Findings underscore the importance of early and ongoing assessment and treatment to ensure low vertical transmission rates and improving postpregnancy outcomes for mothers and children.

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