Pregnancy, somatic complaints and depression: a French population-based study Gise ` le Apter a , Emmanuel Devouche a, *, Vale ´ rie Garez a , Marina Valente b , Marie-Camille Genet a , Maya Gratier c , Joe ¨lle Belaisch-Allart d a Erasme Hospital, Psychiatry and Psychopathology Research Institute, France b Be ´cle `re General Hospital Maternity Ward, France c University Paris Ouest, France d Se `vres General Hospital Maternity Ward, France 1. Introduction Depression during pregnancy is today one of the greatest medical risks both for expectant mothers and newborns. It is associated with a higher risk of numerous medical morbid conditions for both mother and child. It has been positively correlated with pre-eclampsia and premature onset of labor [1,2]. In addition, mental disorders during pregnancy are associated with poor prenatal health care [3,4]. Kelly et al. [4] examined 1 million consecutive deliveries in the US, controlling for socioeconomic status and parity. Women with psychiatric disorders delayed care, and less than 50% of them attended prenatal clinics. Lack of health care heightens the risk of non-detection of major medical issues such as hypertension or gestational diabetes in women, and fetal growth retardation. This, in turn, increases the risk of premature birth, low birth weight for gestational age, and their chain of complications. As for mental health issues, mood disorders such as depression are directly responsible for poor attendance for care due to feelings of worthlessness and increased fatigue. Therefore mental health disorders directly contribute to an increased risk of major peripartum public health issues. Depression during pregnancy is strongly correlated with postnatal depression and with subsequent non-perinatal depres- sion [5]. When associated with a history of abuse and neglect, peripartum depression has been strongly related to impairment of the mother–infant relationship and with negative impact on infant emotional and cognitive development [6]. The association of depression during pregnancy with prematurity and low birth weight, in itself a possible consequence of depressive mood during pregnancy, also puts the infant at high risk of parent–infant interactive dysregulation with an increase in negative emotional European Journal of Obstetrics & Gynecology and Reproductive Biology xxx (2013) xxx–xxx A R T I C L E I N F O Article history: Received 23 February 2013 Received in revised form 3 July 2013 Accepted 3 August 2013 Keywords: Depression during pregnancy Somatic complaints Antenatal OB/GYN screening Early intervention Public Mental Health A B S T R A C T Objective: Depression during pregnancy is today one of the greatest medical risks for expectant mothers and newborns. It is associated with numerous morbid conditions and with postnatal depression. Identifying depression during pregnancy is therefore a major public health concern, but screening for depression is not routinely carried out in somatic settings. We hypothesized that the presence of numerous somatic complaints contributes to the detection of an increased risk of depression during pregnancy. Study design: A cross-sectional study was conducted on 1000 consecutive pregnant women approached during OB/GYN visits at a general maternity hospital. They were asked to fill out a questionnaire, which contained the Edinburgh Postnatal Depression Scale (EPDS) and a checklist of 18 somatic complaints. Results: The median number of somatic complaints was 5 (interquartile range 3–7). The risk of depression during the 2nd and 3rd trimesters was 18.3% (EPDS score > 10.5). Logistic regression revealed that when the somatic complaints total score moved from 3 to 7, the odds of moving from not- at-risk to at-risk for antenatal depression were multiplied by 2.91. Conclusion: Our results call for further research exploring somatic complaints and their link to depression during pregnancy. Until more knowledge is available, we suggest considering that women with a high number of somatic complaints during pregnancy are at high risk for depression and should be referred for further diagnostic clinical assessment and care. ß 2013 Published by Elsevier Ireland Ltd. Abbreviations: OB/GYN, obstetrics and gynecology; EPDS, Edinburgh Postnatal Depression Scale; OR, odds ratio; CI, confidence interval. * Corresponding author at: University Paris Descartes, 71, Avenue Edouard Vaillant, 92100 Boulogne Billancourt, France. Tel.: +33 0155205933. E-mail address: emmanuel.devouche@parisdescartes.fr (E. Devouche). G Model EURO-8210; No. of Pages 5 Please cite this article in press as: Apter G, et al. Pregnancy, somatic complaints and depression: a French population-based study. Eur J Obstet Gynecol (2013), http://dx.doi.org/10.1016/j.ejogrb.2013.08.013 Contents lists available at ScienceDirect European Journal of Obstetrics & Gynecology and Reproductive Biology jou r nal h o mep ag e: w ww .elsevier .co m /loc ate/ejo g rb 0301-2115/$ – see front matter ß 2013 Published by Elsevier Ireland Ltd. http://dx.doi.org/10.1016/j.ejogrb.2013.08.013