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Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
Katrien De Wilde NHPRC2013
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Katrien De Wilde NHPRC2013

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The association of depressive symptoms and smoking during and after pregnancy: a longitudinal study

The association of depressive symptoms and smoking during and after pregnancy: a longitudinal study

Published in: Health & Medicine
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  • 1. The association of depressive symptoms and smoking during and after pregnancy: a longitudinal study Katrien De Wilde, PhDc KAHO Sint-Lieven, Belgium
  • 2. Title after revision Smoking patterns, depression and socio-demographic variables among Flemish Women during Pregnancy and the Postpartum period 2
  • 3. Introduction • Prevalence of smoking during pregnancy in Flanders: 12.3% (Hoppenbrouwer et al. , 2011) • Smoking during pregnancy – Fetal and maternal morbidity (Levitt et al., 2007, Lumley et al., 2009) – Influence on feelings of dysphoria and depression (Park et al., 2009; Scott et al., 2009) • Depression during pregnancy – Pre-term birth (Grote et al., 2010) – Progression to postpartum depression (Bennett et al., 2004) – Misinterpretation of symptoms – Persistent smoking during pregnancy (Scott et al., 2009) 3
  • 4. Aims of the study 1) Which patterns of smoking behavior can be observed during and after pregnancy? 2) Which patterns of depression can be observed during and after pregnancy? 3) Is there a relationship between smoking pattern and feelings of depression during and after pregnancy, independently from socio-demographic characteristics? 4
  • 5. Method • Observational, prospective, non-interventional study • Data collection on 3 moments: T0: < 16weeks pregnancy T1: 32 – 34 weeks pregnancy T2: > 6 weeks postpartum • Questionnaire: Smoking behavior (partner) Socio-demographic variables: age, gravidity, educational level, job status Beck Depression Inventory (BDI) (Beck et al., 1979) 5
  • 6. Results: smoking patterns 6 Smoking pattern Explanation Number of respondents Attrition Smokers Persistent smokers 53 35 Non-smokers Never smoking OR quit > 1 year prior to T0 416 32 Recent ex- smokers Non-smokers quit ≤ 1 year prior to T0 30 15 Initial smokers Smokers who quit at T1 or T2 14 0 Initial non- smokers Relapsed at T1 or T2 10 0 Total 523 82
  • 7. Results: patterns of depression 7 Time point Smokers Non- smokers Recent ex-smokers Initial smokers Initial non- smokers T0 Mean BDI 11.17 6.09 6.95 10.77 7.71 Range 0 - 36 0 - 24 0 - 29 3 - 19 3 - 13 T1 Mean BDI 11.28 7.45 7.02 12.33 6.00 Range 0 - 42 0 - 31 0 - 33 4 - 19 3 - 10 T2 Mean BDI 9.61 4.22 5.29 7.69 5.56 Range 0 - 31 0 - 13 0 - 21 0 - 18 1 - 13
  • 8. Results of univariable analysis • Significant higher BDI-scores: – Smokers and initial smokers (F(4,486) = 12.06; p < 0.001) – Low educated women (F(1,496) = 40.39; p < 0.0001) – Women without a job (F(1,489) = 6.14; p = 0.0136) – During pregnancy (F(2, 643) = 40.15; p < 0.0001) – Having a smoking partner (F(1, 495) = 5.37; p < 0.021) – Women younger than 29 years (F(1, 495) = 7.11; p < 0.0079) 8
  • 9. Results of multivariable analysis 9 Low educational level High educational level Mean BDI score according to smoking pattern and educational level at T0, T1 and T2 (F(8,619) = 2.29; p = 0.02)
  • 10. Conclusions • Recent ex-smokers reported less symptoms of depression compared to smokers and initial smokers, independent of their educational level, suggesting that smoking cessation shortly before or in early pregnancy does not aggravate depressive symptoms during pregnancy and in postpartum. • Mean BDI scores decreased in postpartum, except in low educated smokers, where BDI scores remained constantly above ten during pregnancy and postpartum, suggesting that smoking could be a way of coping with difficult life conditions. 10
  • 11. Conclusions • Ex-smokers and initial smokers had the highest percentage of smoking partners (71.1 and 71.4% respectively). This means that women who recently attempted quitting, are more at risk for relapse and that their partner should be involved in smoking cessation counseling. 11
  • 12. Limitations • Relatively high drop-out rate of 13.56% • Partially due to our own strict exclusion criteria for smokers (39.8%) and recent ex-smokers (33.3%) 12
  • 13. Implications for practice • Take enough time to explore not only obstetric parameters, but also the lifestyle of the pregnant woman during a first consultation. • Identify those women who may need more specialized care and offer smoking cessation counseling tailored to their needs and possibilities. • Consider measuring the level of depression in pregnant women, e.g. by using the BDI. • If possible, involve the partner. 13
  • 14. Acknowledgements • Supervisors: – Prof. L. Maes, PhD, UGhent – Prof. M. Temmerman, PhD, MD, UGhent – Prof. H. Boudrez, PhD, UGhent – L. Trommelmans, PhD, KAHO Sint-Lieven – H. Laevens, PhD, KAHO Sint-Lieven Further information: katrien.dewilde@kahosl.be 14

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