Cargando…

Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study

OBJECTIVE: This study examined the association of anxiety alone, depression alone and the presence of both anxiety and depression with preterm birth (PTB) and further examined whether neighbourhood socioeconomic status (SES) modified this association. DESIGN: Cohort study using individual-level data...

Descripción completa

Detalles Bibliográficos
Autores principales: Adhikari, Kamala, Patten, Scott B, Williamson, Tyler, Patel, Alka B, Premji, Shahirose, Tough, Suzanne, Letourneau, Nicole, Giesbrecht, Gerald, Metcalfe, Amy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045250/
https://www.ncbi.nlm.nih.gov/pubmed/32047008
http://dx.doi.org/10.1136/bmjopen-2019-031035
_version_ 1783501743272755200
author Adhikari, Kamala
Patten, Scott B
Williamson, Tyler
Patel, Alka B
Premji, Shahirose
Tough, Suzanne
Letourneau, Nicole
Giesbrecht, Gerald
Metcalfe, Amy
author_facet Adhikari, Kamala
Patten, Scott B
Williamson, Tyler
Patel, Alka B
Premji, Shahirose
Tough, Suzanne
Letourneau, Nicole
Giesbrecht, Gerald
Metcalfe, Amy
author_sort Adhikari, Kamala
collection PubMed
description OBJECTIVE: This study examined the association of anxiety alone, depression alone and the presence of both anxiety and depression with preterm birth (PTB) and further examined whether neighbourhood socioeconomic status (SES) modified this association. DESIGN: Cohort study using individual-level data from two community-based prospective pregnancy cohort studies (All Our Families; AOF) and Alberta Pregnancy Outcomes and Nutrition (APrON) and neighbourhood SES data from the 2011 Canadian census. SETTING: Calgary, Alberta, Canada. PARTICIPANTS: Overall, 5538 pregnant women who were <27 weeks of gestation and >15 years old were enrolled in the cohort studies between 2008 and 2012. 3341 women participated in the AOF study and 2187 women participated in the APrON study, with 231 women participated in both studies. Women who participated in both studies were only counted once. PRIMARY AND SECONDARY OUTCOME MEASURES: PTB was defined as delivery prior to 37 weeks of gestation. Depression was defined as an Edinburgh Postnatal Depression Scale (EPDS) score of ≥13, anxiety was defined as an EPDS-anxiety subscale score of ≥6, and the presence of both anxiety and depression was defined as meeting both anxiety and depression definitions. RESULTS: Overall, 7.3% of women delivered preterm infants. The presence of both anxiety and depression, but neither of these conditions alone, was significantly associated with PTB (OR 1.6, 95% CI 1.1 to 2.3) and had significant interaction with neighbourhood deprivation (p=0.004). The predicted probability of PTB for women with both anxiety and depression was 10.0%, which increased to 15.7% if they lived in the most deprived neighbourhoods and decreased to 1.4% if they lived in the least deprived neighbourhoods. CONCLUSIONS: Effects of anxiety and depression on risk of PTB differ depending on where women live. This understanding may guide the identification of women at increased risk for PTB and allocation of resources for early identification and management of anxiety and depression.
format Online
Article
Text
id pubmed-7045250
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-70452502020-03-09 Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study Adhikari, Kamala Patten, Scott B Williamson, Tyler Patel, Alka B Premji, Shahirose Tough, Suzanne Letourneau, Nicole Giesbrecht, Gerald Metcalfe, Amy BMJ Open Epidemiology OBJECTIVE: This study examined the association of anxiety alone, depression alone and the presence of both anxiety and depression with preterm birth (PTB) and further examined whether neighbourhood socioeconomic status (SES) modified this association. DESIGN: Cohort study using individual-level data from two community-based prospective pregnancy cohort studies (All Our Families; AOF) and Alberta Pregnancy Outcomes and Nutrition (APrON) and neighbourhood SES data from the 2011 Canadian census. SETTING: Calgary, Alberta, Canada. PARTICIPANTS: Overall, 5538 pregnant women who were <27 weeks of gestation and >15 years old were enrolled in the cohort studies between 2008 and 2012. 3341 women participated in the AOF study and 2187 women participated in the APrON study, with 231 women participated in both studies. Women who participated in both studies were only counted once. PRIMARY AND SECONDARY OUTCOME MEASURES: PTB was defined as delivery prior to 37 weeks of gestation. Depression was defined as an Edinburgh Postnatal Depression Scale (EPDS) score of ≥13, anxiety was defined as an EPDS-anxiety subscale score of ≥6, and the presence of both anxiety and depression was defined as meeting both anxiety and depression definitions. RESULTS: Overall, 7.3% of women delivered preterm infants. The presence of both anxiety and depression, but neither of these conditions alone, was significantly associated with PTB (OR 1.6, 95% CI 1.1 to 2.3) and had significant interaction with neighbourhood deprivation (p=0.004). The predicted probability of PTB for women with both anxiety and depression was 10.0%, which increased to 15.7% if they lived in the most deprived neighbourhoods and decreased to 1.4% if they lived in the least deprived neighbourhoods. CONCLUSIONS: Effects of anxiety and depression on risk of PTB differ depending on where women live. This understanding may guide the identification of women at increased risk for PTB and allocation of resources for early identification and management of anxiety and depression. BMJ Publishing Group 2020-02-10 /pmc/articles/PMC7045250/ /pubmed/32047008 http://dx.doi.org/10.1136/bmjopen-2019-031035 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Epidemiology
Adhikari, Kamala
Patten, Scott B
Williamson, Tyler
Patel, Alka B
Premji, Shahirose
Tough, Suzanne
Letourneau, Nicole
Giesbrecht, Gerald
Metcalfe, Amy
Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study
title Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study
title_full Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study
title_fullStr Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study
title_full_unstemmed Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study
title_short Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study
title_sort neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a community-based canadian cohort study
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045250/
https://www.ncbi.nlm.nih.gov/pubmed/32047008
http://dx.doi.org/10.1136/bmjopen-2019-031035
work_keys_str_mv AT adhikarikamala neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT pattenscottb neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT williamsontyler neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT patelalkab neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT premjishahirose neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT toughsuzanne neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT letourneaunicole neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT giesbrechtgerald neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy
AT metcalfeamy neighbourhoodsocioeconomicstatusmodifiestheassociationbetweenanxietyanddepressionduringpregnancyandpretermbirthacommunitybasedcanadiancohortstudy