Depression During Pregnancy and the Risk of Preterm Birth, Low Birth Weight, and Intrauterine Growth Restriction

Abstract

Background:
Depression during pregnancy is a common yet underdiagnosed condition and is increasingly recognized as an important risk
factor for adverse neonatal outcomes such as preterm birth, low birth weight, and intrauterine growth restriction. Early
detection and timely intervention may reduce maternal and fetal complications.
Objectives:
To determine the prevalence of antenatal depression and evaluate its association with preterm birth, low birth weight,
intrauterine growth restriction (IUGR), and NICU admission among pregnant women attending a tertiary care centre.
Methods:
A hospital-based prospective cohort study was conducted in the Department of Obstetrics and Gynaecology at Chettinad
Hospital and Research Institute, Tamil Nadu. A total of 250 antenatal women (28–36 weeks gestation) with singleton
pregnancies were enrolled using consecutive sampling. Depressive symptoms were assessed using the Edinburgh Postnatal
Depression Scale (EPDS). Participants were followed until delivery and neonatal outcomes were recorded from hospital
records. Associations between antenatal depression and adverse outcomes were analyzed using the Chi-square test, and
predictors of depression were identified using logistic regression.
Results:
The prevalence of antenatal depression (EPDS ≥10) was 26.0%, including 13.6% possible depression and 12.4% probable
depression. Preterm birth occurred in 26.2% of depressed women compared to 8.1% in non-depressed women (p <0.001). Low
birth weight was observed in 35.4% of neonates born to depressed mothers versus 11.9% among non-depressed mothers (p
<0.001). IUGR was present in 23.1% of depressed women compared to 7.6% in non-depressed women (p = 0.001). NICU
admission was significantly higher in neonates of depressed mothers (27.7% vs 10.8%; p = 0.003). Independent predictors of
antenatal depression included low socio-economic status (AOR 2.4), unplanned pregnancy (AOR 2.9), poor spousal/family
support (AOR 3.7), and previous adverse pregnancy outcome (AOR 2.1).
Conclusion:
Antenatal depression affected approximately one-fourth of pregnant women in this tertiary care cohort and was significantly
associated with increased risk of preterm birth, low birth weight, IUGR, and NICU admission. Integrating routine depression
screening into antenatal care and strengthening psychosocial support may improve maternal wellbeing and neonatal outcomes.