PAIN AND DEPRESSION SYMPTOMS DURING THE THIRD TRIMESTER OF PREGNANCY

Purpose: To assess the association between depression symptoms and pain characteristics, including pain intensity, location, and effectiveness of pain management strategies, among women in their third trimester of pregnancy. Design: Descriptive, exploratory cross-sectional study. Setting: Mobile health pregnancy application (app). Participants: A convenience sample of women in their third trimester of pregnancy from across the United States. Methods: Women completed demographic questionnaires, the Brief Pain Inventory, and Edinburgh Postnatal Depression Scale (EPDS) through an online Web site. Results: N = 132 women participated. The sample was demographically diverse.. Women ranged in age from 18 to 39 years (M 28.1 +/- SD 5.2). Most women were Caucasian (68%), with smaller percentages of Hispanic (12%) and African American (11%) women. Most had commercial insurance (59%) and a partner (85%). Of the 132 women, 79.6% reported moderate-to-severe pain. Approximately 93% experienced back and pelvic pain, whereas 27% experienced moderate-to-severe depression symptoms. Bivariate and linear regression analyses revealed that higher EPDS depression scores were associated with higher levels of pain (p <.01). Other variables signifi cantly associated with higher EPDS scores were White race (p =.04), marital status (p =.05), and headache (p <.01). Clinical Implications: In the third trimester of pregnancy, pain affects more than two-thirds of women and may occur with and without depression symptoms. A lthough the value of universal depression screening during pregnancy is widely recognized, our findings suggest clinical outcomes for pregnant women would improve with a standardized, multidimensional screen for both pain and depression symptoms. Nurses are ideally positioned to assess and advocate for the combined treatment of pain and depression.