Investigating the interplay between depression and pregnancy loss: a cross-sectional analysis using NHANES data

Objective This study aimed to investigate the association between depressive symptoms and pregnancy losses, as well as the moderating effects of demographic variables, including age, income level and ethnicity. Methods Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) questionnaire, with key variables such as "loss of interest," "feeling down," and "sleep disturbances." Weighted linear regression models evaluated the relationship between depressive symptoms and pregnancy losses, while interaction analyses explored the moderating effects of demographic factors. Results The findings revealed a significant positive association between depressive symptoms and pregnancy losses. Severe symptoms, particularly "thoughts of self-harm" (p = .013), were strongly linked to multiple losses. Other symptoms such as "feeling down" (p < .001) and "feeling bad about oneself" (p < .001) were also significantly associated. The association was most pronounced among women aged 35-50. Additionally, the effect of depressive symptoms was more significant among low-income and minority women, suggesting socioeconomic and cultural factors play a role. Conclusions Depression, especially major depression, is significantly associated with an increased number of pregnancy losses, particularly among women aged 35-50. Socioeconomic and cultural factors are influential, highlighting the need for targeted interventions in high-risk groups.