OBJECTIVE--The aim was to examine the association between depressive symptoms and smoking in pregnancy and to investigate the part played by social and psychosocial factors. SETTING--A single Glasgow hospital. DESIGN--Prospective survey by postal questionnaires at 20 and 30 weeks' gestation. PARTICIPANTS--A total of 395 women (69% of the 572 eligible) parity 1 who booked for delivery between November 1988 and February 1990 took part. MEASUREMENTS--Depressive symptoms were measured using the Hospital Anxiety and Depression Scale. Smoking was self reported. The Life Events Inventory and measures of role specific strain and stress in domestic roles were used to assess psychosocial well being. MAIN RESULTS--Smokers were more likely than non-smokers to experience depressive symptoms at 20 and 30 weeks' gestation and on both occasions. The excess risk remained substantial and significant after adjustment for social and psychosocial factors. CONCLUSIONS--Smoking is a significant risk factor for depression in pregnancy. The association of smoking with depression and psychosocial difficulty represents a major problem for interventions intended to reduce smoking in pregnancy.
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