2 achievements (education and work), sexual development, family conﬂicts, sociocultural issues, substance use/abuse, antisocial behaviour, among others. Individuals with high resilience are less likely to engage in risky behaviors [7]. Furthermore, complex relationships exist between depressive symptoms and resilience in adolescents. Despite the fact that resilience is important for adoles- cent personality maturation, up-to-date, studies assessing depressive symptoms, and resilience speciﬁcally in pregnant adolescents are still lacking. The present study aimed at assessing depressive symptoms and resilience among preg- nant adolescents. It was hypothesized that prevalence of depressed mood would be greater and resilience lower among adolescents as compared to controls aged 20 to 30 years. Studies addressing resilience during pregnancy are scarce [8–10]. It has been assessed during pregnancy in various stressful situations: after ultrasound consultation for fetal malformations [8] and after exposure to a hurricane [9]. Another report examined resilience factors (maturity, self- esteem, and mother-grandmother relationships) shortly after delivery and parenting behavior at 6 months although no speciﬁc resilience measuring tool was used [10]. Despite the fact that resilience is important for adolescent personality maturation, up-to-date, studies assessing depressive symp- toms and resilience speciﬁcally in pregnant adolescents are still lacking. The present study aimed at assessing depressive symptoms and resilience among pregnant adolescents. It was hypothesized that prevalence of depressed mood would be greater and resilience lower among adolescents as compared to controls aged 20 to 30 years. 2. Methods 2.1. Study Design and Participants. This case-control study was carried out from 1 February 2010 to 30 April 2010 in the Labor and Delivery Unit of the Enrique C. Sotomayor Obstetrics and Gynecology Hospital of Guayaquil, Ecuador after approval of the institution’s Scientiﬁc, Research and Ethics Committee. Nulliparous women aged 19 or less, delivering at this facility a live, single child of more than 20 weeks in the working shifts of one of the authors (D.S-P; 12 hrs every 24 hrs) were considered eligible to be included as cases (adolescents). Those with an abortion and/or still births were excluded. Each teenager was surveyed in the ﬁrst postpartum hour with a structured questionnaire containing general maternal data, the 10-item Center for Epidemiologic Studies Short Depression Scale (CESD-10) and the 14 item Wagnild and Young Resilience Scale (RS) [11–13]. Survey was pretested on several teenagers prior to the initiation of the study. Maternal and neonatal outcome data were directly assessed from the medical records of each subject. Delivery of a nulliparous woman (20 to 30 years) right after each indexed case was selected as the corresponding control. Controls were identiﬁed through the delivery log book and surveyed in the same fashion as cases. Participants were informed of the study, its objectives, and conﬁdentiality and their full right to discontinue or refuse participation. Interviews were maintained anonymous and consent obtained orally. Obstetrics and Gynecology International The Enrique C. Sotomayor Obstetrics and Gynecology Hospital of Guayaquil, Ecuador, performs more than 30,000 deliveries per year, attending basically gravid women of low socioeconomic income of Guayaquil, the major coastal city of Ecuador with a population above 3 million inhabitants. Approximately 25% of annual deliveries correspond to those aged 19 or less [14]. 2.2. Center for Epidemiologic Studies Short Depression Scale (CESD-10). The CESD-10 is a 10-item questionnaire assess- ing how individuals feel during the past week. This is a short version of the 20-item CESD tool. Each item can be graded according to a Likert scale: rarely or none of the time, <1 day (0 points); some or a little of the time, 1-2 days (1 point); occasionally or a moderate amount of time, 3-4 days (2 points); and all the time, 5 to 7 days (3 points). Items 5 and 8 are scored inversely. Final score is the sum of the 10 graded items with scores 10 or greater considered as depressed mood [11, 12]. 2.3. The Resilience Scale (RS). The 14-item Wagnild and Young Resilience Scale (RS) was used to assess resilience status. This scale was constructed after interviewing resilient subjects and hence is an accurate tool for studying resilience. It is a Likert type scale used in various age groups and diﬀerent conditions. Each item can be graded from “1” (strongly disagree) to “7” (strongly agree) [13]. Graded items are summed up to provide a total score. Although no cut-oﬀ value for abnormality is available, lower scores indicate less resilience. 2.4. Sample Size Calculation. It has been reported that 10– 20% of all pregnancies may present depressed mood [5], with a 46% found among teens [15]. Hence, assuming a 15% prevalence of depressive symptoms in the control group, a sample size of 125 subjects per group (cases and controls) was calculated in order to detect a 2.5 increased risk of depressed mood among adolescents with an 80% power and a 95% conﬁdence level. 2.5. Statistical Analysis. Analysis was performed using sta- tistical packages: SPSS (Version 10.0 for Windows, SPSS, Chicago, IL, USA) and EPI-INFO 6.04 (Centers for Disease Control and Prevention, Atlanta, GA, USA/World Health Organization, Geneva, Switzerland). Data are presented as mean ± standard deviations, medians, percentages, odds ratios (OR), and conﬁdence intervals (CI). Kolmogorov Smirnov’s test was used to determine normality of data distribution. According to this, continuous nonparametric paired data was compared with the Wilcoxon signed-rank test. Percentages were compared with the chi-square or Fisher’s exact test. Logistic regression analysis was used to determine risk factors related to depressed mood (Total CESD-10 scores 10 or more) and lower resilience (Lower total RS scores). Variables included in the regression model were those related to the: mother (age, habits, marital status, place of residency, adequacy of prenatal care), pregnancy (maternal and neonatal outcome data), and the partner