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Depressed pregnant women have twice the risk of preterm delivery than pregnant women with no symptoms of depression, the Kaiser Permanente Division of Research reported in Oxford University Press's journal Human Reproduction.

The risk grows with the severity of the depressive symptoms, according to researchers led by De-Kun Li, MD, PhD, MPH, a Kaiser reproductive and perinatal epidemiologist.

The study, which adds to other preterm delivery risks such as obesity and stress, featured 791 San Francisco-area women who did not use antidepressants. In the 10th week of pregnancy, 41% percent reported significant or severe depressive symptoms, resulting in a 60% higher risk of delivery before 37 weeks of gestation, researchers say.

Noting that a healthy placenta depends on hormones which are controlled by the brain, Li said the study "adds to emerging evidence that depression during early pregnancy may interfere with the neuroendocrine pathways and subsequently placental function."

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