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Open Access Highly Accessed Research article

Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: results from a population based study in Bangladesh

Hashima E Nasreen123*, Zarina Nahar Kabir3, Yvonne Forsell4 and Maigun Edhborg3

Author Affiliations

1 Research and Evaluation Division, BRAC, 75 Mohakhali, Dhaka 1212, Bangladesh

2 School of Public Health, BRAC, 66 Mohakhali, Dhaka 1212, Bangladesh

3 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Stockholm, Sweden

4 Department of Public Health, Karolinska Institutet, SE-17176 Stockholm, Sweden

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BMC Public Health 2010, 10:515  doi:10.1186/1471-2458-10-515

Published: 26 August 2010

Abstract

Background

There is a high prevalence of antepartum depression and low birth weight (LBW) in Bangladesh. In high- and low-income countries, prior evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting. There is no research on the association between maternal mental disorders and LBW in Bangladesh. This study aims to investigate the independent effect of maternal antepartum depressive and anxiety symptoms on infant LBW among women in a rural district of Bangladesh.

Methods

A population-based sample of 720 pregnant women from two rural subdistricts was assessed for symptoms of antepartum depression, using the Edinburgh Postpartum Depression Scale (EPDS), and antepartum anxiety, using the State Trait Anxiety Inventory (STAI), and followed for 6-8 months postpartum. Infant birth weight of 583 (81%) singleton live babies born at term (≥37 weeks of pregnancy) was measured within 48 hours of delivery. Baseline data provided socioeconomic, anthropometric, reproductive, obstetric, and social support information. Trained female interviewers carried out structured interviews. Chi-square, Fisher's exact, and independent-sample t tests were done as descriptive statistics, and a multiple logistic regression model was used to identify predictors of LBW.

Results

After adjusting for potential confounders, depressive (OR = 2.24; 95% CI 1.37-3.68) and anxiety (OR = 2.08; 95% CI 1.30-3.25) symptoms were significantly associated with LBW (≤2.5 kg). Poverty, maternal malnutrition, and support during pregnancy were also associated with LBW.

Conclusions

This study provides evidence that maternal depressive and anxiety symptoms during pregnancy predict the LBW of newborns and replicates results found in other South Asian countries. Policies aimed at the detection and effective management of depressive and anxiety symptoms during pregnancy may reduce the burden on mothers and also act as an important measure in the prevention of LBW among offspring in Bangladesh.