학술논문

Depressive Symptoms and Gestational Length Among Pregnant Adolescents: Cluster Randomized Control Trial of CenteringPregnancy® Plus Group Prenatal Care
Document Type
article
Source
Journal of Consulting and Clinical Psychology. 85(6)
Subject
Psychology
Clinical and Health Psychology
Social and Personality Psychology
Applied and Developmental Psychology
Clinical Research
Pediatric
Perinatal Period - Conditions Originating in Perinatal Period
Depression
Conditions Affecting the Embryonic and Fetal Periods
Mental Health
Infant Mortality
Clinical Trials and Supportive Activities
Preterm
Low Birth Weight and Health of the Newborn
Pediatric Research Initiative
Prevention
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Reproductive health and childbirth
Good Health and Well Being
Adolescent
Female
Gestational Age
Humans
New York City
Postpartum Period
Pregnancy
Pregnancy Complications
Pregnancy Trimester
Third
Pregnancy in Adolescence
Prenatal Care
Young Adult
perinatal
depression
preterm birth
group prenatal care
cluster randomized controlled trial
Clinical Psychology
Applied and developmental psychology
Clinical and health psychology
Social and personality psychology
Language
Abstract
ObjectivesDepressive symptoms are associated with preterm birth among adults. Pregnant adolescents have high rates of depressive symptoms and low rates of treatment; however, few interventions have targeted this vulnerable group. Objectives are to: (a) examine impact of CenteringPregnancy® Plus group prenatal care on perinatal depressive symptoms compared to individual prenatal care; and (b) determine effects of depressive symptoms on gestational age and preterm birth among pregnant adolescents.MethodThis cluster-randomized controlled trial was conducted in 14 community health centers and hospitals in New York City. Clinical sites were randomized to receive standard individual prenatal care (n = 7) or CenteringPregnancy® Plus group prenatal care (n = 7). Pregnant adolescents (ages 14-21, N = 1,135) completed the Center for Epidemiologic Studies Depression Scale during pregnancy (second and third trimesters) and postpartum (6 and 12 months). Gestational age was obtained from medical records, based on ultrasound dating. Intention to treat analyses were used to examine objectives.ResultsAdolescents at clinical sites randomized to CenteringPregnancy® Plus experienced greater reductions in perinatal depressive symptoms compared to those at clinical sites randomized to individual care (p = .003). Increased depressive symptoms from second to third pregnancy trimester were associated with shorter gestational age at delivery and preterm birth (