The moderating role of depression in the association between hypertension during pregnancy and birth outcomes

ABSTRACT

Objective

Investigate how hypertension during pregnancy (HDP) and depression during pregnancy (DDP) independently and jointly affect infant birth outcomes.

Methods

This population-based, retrospective cohort study included a sample of 68,052 women who participated in PRAMS 2016–2018 survey. Poisson regression was used for adjusted relative risks (aRRs).

Results

Compared to women without HDP and DDP, aRRs for PTB and LBW among women with both HDP and DDP are 2.04 (95% CI 1.73, 2.42) and 2.84 (95% CI 2.27, 3.56), respectively, albeit lower than the expected joint effect of risk.

Conclusion

DDP may modify the association between HDP and PTB, LBW.

KEYWORDS:

• Hypertension
• depression
• preterm birth
• pregnancy
• low birth weight

Acknowledgments

We would like to thank the PRAMS (Pregnancy Risk Assessment Monitoring System) Working Group for its role in conducting PRAMS surveillance.

Disclosure statement

No potential conflict of interest was reported by the author(s).

The PRAMS working group representatives

Alabama – Tammie Yelldell, MPH; Alaska – Kathy Perham-Hester, MS, MPH; Arizona – Enid Quintana-Torres, MPH; Arkansas – Letitia de Graft-Johnson, DrPH, MHSA; Colorado – Ashley Juhl, MSPH; Connecticut – Jennifer Morin, MPH; Delaware – George Yocher, MS; Florida – Tara Hylton, MPH; Georgia – Florence A. Kanu, PhD, MPH; Hawaii – Matt Shim, PhD, MPH; Illinois – Julie Doetsch, MA; Indiana – Brittany Reynolds, MPH; Iowa – Jennifer Pham; Kentucky – Tracey D. Jewell, MPH; Louisiana – Rosaria Trichilo, MPH; Maine – Tom Patenaude, MPH; Maryland – Laurie Kettinger, MS; Massachusetts – Hafsatou Diop, MD, MPH; Michigan – Peterson Haak; Minnesota – Mira Grice Sheff, PhD, MS; Mississippi – Brenda Hughes, MPPA; Missouri – Venkata Garikapaty, PhD; Montana – Emily Healy, MS; Nebraska – Jessica Seberger; New Hampshire – David J. Laflamme, PhD, MPH; New Jersey – Sharon Smith Cooley, MPH; New Mexico – Sarah Schrock, MPH; New York State – Anne Radigan; New York City – Lauren Birnie, MPH; North Carolina – Kathleen Jones-Vessey, MS; North Dakota – Grace Njau, MPH; Oklahoma – Ayesha Lampkins, MPH, CHE; Oregon – Cate Wilcox, MPH; Pennsylvania – Sara Thuma, MPH; Puerto Rico – Wanda Hernandez, MPH; Rhode Island – Karine Tolentino Monteiro, MPH; South Carolina – Harley T. Davis, PhD, MPSH; South Dakota – Maggie Minett; Texas – Tanya Guthrie, PhD; Tennessee – Ransom Wyse, MPH, CPH; Utah – Nicole Stone, MPH; Vermont – Peggy Brozicevic; Virginia – Kenesha Smith, PhD, MSPH; Washington – Linda Lohdefinck; West Virginia – Melissa Baker, MA; Wisconsin – Fiona Weeks, MSPH; Wyoming – Lorie Chesnut, PhD; and the CDC PRAMS Team, Women”s Health and Fertility Branch, Division of Reproductive Health.

Data availability statement

The data that support the findings of this study are openly available via a data application to PRAMS at https://www.cdc.gov/prams/prams-data/researchers.htm.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.