DEPRESSIVE SYMPTOMS, STRESS, AND SOCIAL SUPPORT IN PREGNANT AND POSTPARTUM ADOLESCENTS

Objective: To assess prospectively the incidence and course of depress ive symptoms among pregnant and postpartum adolescents and explore the roles of stress and social support as influencing factors. Methods: P regnant teenagers attending a comprehensive adolescent pregnancy and p arenting program were enrolled during their third trimester of pregnan cy and followed up through 4 months post partum. Depressive symptoms a nd social support were measured with validated, self-administered inst ruments during the third trimester and at 2 and 4 months post partum. Stress was measured during the prenatal and postpartum periods. Result s: Study participants (N=125) were predominantly black (93%) and were aged 12 to 18 years. Completed assessments were obtained from 114 subj ects at 2 months post partum and 108 at 4 months. Forty-two percent ha d significant depressive symptoms in the third trimester, with 36% and 32% having scores that indicated depression at 2 and 4 months post pa rtum. Stress levels increased significantly from the third trimester t o the postpartum period (P<.01) and were positively associated with de pressive symp toms. Receiving social support from the adolescent's mot her or the infant's father, especially in the postpartum period, was s ignificantly associated with lower rates of depression. Reporting conf lict with the infant's father was strongly associated with increased r ates of depressive symptoms. Conclusions: Results indicate that depres sive symptoms are common among pregnant teenagers and postpartum adole scents. Stress and social support appear to be important mediators. Id entifying those teenagers with high stress and conflict and low levels of support will help identify those who are at particular risk for de pressive symptoms.