BMJ  2005;331:1303 (3 December), doi:10.1136/bmj.38623.532384.55 (published 28 October 2005)

Paper

Depression and unwanted first pregnancy: longitudinal cohort study

Sarah Schmiege, postdoctoral research associate1, Nancy Felipe Russo, regents professor2

1 Department of Psychology UCB 345, University of Colorado, Boulder, CO 80309-0345, USA, 2 Department of Psychology, Arizona State University, Box 871104, Tempe, AZ 85287-1104, USA

Correspondence to: N F Russo nancy.russo{at}asu.edu

Objective To examine the outcomes of an unwanted first pregnancy (abortion v live delivery) and risk of depression and to explain discrepancies with previous research that used the same dataset.

Design Longitudinal cohort study.

Setting Nationally representative sample of US men and women aged 14-24 in 1979.

Participants 1247 women in the US national longitudinal survey of youth who aborted or delivered an unwanted first pregnancy.

Main outcome measures Clinical cut-off and continuous scores on a 1992 measure of the Center for Epidemiological Studies depression scale.

Results Terminating compared with delivering an unwanted first pregnancy was not directly related to risk of clinically significant depression (odds ratio 1.19, 95% confidence interval 0.85 to 1.66). No evidence was found of a relation between pregnancy outcome and depression in analyses of subgroups known to vary in under-reporting of abortion. In analyses of the characteristics of non-respondents, refusal to provide information on abortion did not explain the lack of detecting a relation between abortion and mental health. The abortion group had a significantly higher mean education and income and lower total family size, all of which were associated with a lower risk of depression.

Conclusions Evidence that choosing to terminate rather than deliver an unwanted first pregnancy puts women at higher risk of depression is inconclusive. Discrepancies between current findings and those of previous research using the same dataset primarily reflect differences in coding of a first pregnancy.


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Biased sample
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