Antepartum Depressive Symptomatology Is Associated With Adverse Obstetric and Neonatal Outcomes

TLDR

Previous studies have linked antepartum anxiety or stress to growth retardation, premature delivery, and epidural analgesia. The study aimed to determine whether depressive symptomatology during pregnancy is linked to adverse obstetric and neonatal outcomes. A prospective observational study followed 959 women from early pregnancy to postpartum, measuring depression with the Beck Depression Inventory at baseline and late pregnancy and recording obstetric and neonatal outcomes at delivery. Late‑pregnancy depression was linked to higher rates of epidural analgesia, operative deliveries, and neonatal care unit admissions, and these associations persisted after adjusting for confounders, underscoring the adverse impact of antepartum psychological morbidity on maternal and neonatal well‑being.

Abstract

Objective The purpose of this study was to examine if depressive symptomatology in pregnancy is associated with adverse obstetric and neonatal outcomes. Method In a prospective observational study, 959 women were followed up longitudinally from early pregnancy to postpartum. The level of depression was measured at baseline (first antepartum visit) and in late pregnancy using the Beck Depression Inventory (BDI). Adverse obstetric and neonatal outcomes were recorded at delivery. Results Depression in late pregnancy was associated with increased risk of epidural analgesia (33% vs. 19%, p = .01, adjusted RR = 2.56, 95% CI 1.24–5.30), operative deliveries (caesarean sections and instrumental vaginal deliveries) (39% vs. 27%, p = .02, adjusted RR = 2.28, 95% CI 1.15–4.53), and admission to neonatal care unit (24% vs. 19%, p = .03, adjusted RR = 2.18, 95% CI 1.02–4.66). These effects remained significant even when controlled for potential confounders, such as antepartum complications. Conclusion Previous studies have shown that antepartum anxiety or stress was associated with growth retardation, premature delivery, and epidural analgesia. Our findings add to this body of evidence, which together suggest an adverse impact of antepartum psychological morbidity on maternal and neonatal well-being.