Rates and Correlates of Depression Symptoms in a Sample of Pregnant Veterans Receiving Veterans Health Administration Care

UMMS Affiliation

Department of Population and Quantitative Health Sciences; Graduate School of Nursing; Department of Obstetrics and Gynecology

Publication Date


Document Type



Health Services Administration | Health Services Research | Maternal and Child Health | Mental and Social Health | Military and Veterans Studies | Psychiatry and Psychology | Women's Health


BACKGROUND: Depression is the most commonly diagnosed medical condition among women veterans ages 18 to 44; however, depression symptoms occurring during pregnancy have not been well-studied in this population.

METHODS: Pregnant veterans were recruited from 15 Veterans Health Administration sites across the United States; our sample included 501 participants. Sociodemographic characteristics, military service, health status, and pregnancy related factors, as well as the Edinburgh Postnatal Depression Scale (EPDS) were collected as part of a telephone survey. Additional data were obtained from electronic health record data. We used multivariable logistic regression models to examine factors associated with an EPDS score suggestive of clinically significant depressive symptoms ( > /=10).

FINDINGS: Prenatal EPDS scores of 10 or greater were calculated for 28% of our sample. Our final model indicated that factors associated with decreased odds of an EPDS score of 10 or greater included spousal or partner support during pregnancy (adjusted odds ratio [aOR], 0.35; 95% confidence interval [CI], 0.16-0.77) and employment (aOR, 0.40; 95% CI, 0.24-0.67). A past diagnosis of anxiety (aOR, 2.54; 95% CI, 1.43-4.50), past antidepressant use (aOR, 3.27; 95% CI, 1.71-6.24), and active duty service (aOR, 1.91; 95% CI, 1.08-3.37) were associated with increased odds of having an EPDS score of 10 or greater.

CONCLUSIONS: This is the first quantitative estimate of depression symptoms in pregnant veterans across multiple veterans affairs facilities. The prevalence of depression symptomology was greater than the high end of prevalence estimates in the general pregnant population. Given that the risk of depression increases during the postpartum period, women who can be identified with depressive symptomatology during pregnancy can be offered critical resources and support before giving birth.

DOI of Published Version



Womens Health Issues. 2019 May 16. pii: S1049-3867(18)30486-9. doi: 10.1016/j.whi.2019.04.008. [Epub ahead of print] Link to article on publisher's site

Journal/Book/Conference Title

Women's health issues : official publication of the Jacobs Institute of Women's Health

PubMed ID


Related Resources

Link to Article in PubMed