Impact of Maternal Depression on Pregnancy and Neonatal Outcomes: A Prospective Analysis
Maternal Stress and Neonatal Outcomes
DOI:
https://doi.org/10.54393/pjhs.v5i10.2158Keywords:
Antenatal Depression, Neonatal Outcomes, Preterm Delivery, C-SectionAbstract
Antenatal depression was common in pregnant women and can cause adverse maternal and neonatal outcomes. Objective: This study was conducted to evaluate the incidence of antenatal depression in hospitalized pregnant women and its association with maternal and neonatal outcomes. Methods: A prospective observational study was conducted in the Gynecology and Obstetrics and Psychiatry Department of the Hospital from July 2023 to July 2024. A total of 300 pregnant women with gestation age 240/7 weeks or less, admitted to the OBGYN department as high-risk pregnancy patients were selected by consecutive sampling. Women were presented with the Edinburgh Post Natal Depression Scale questionnaire 2-4 times every week for the entire study period along with questionnaires to personal collect data. EPDS was generally used to assess post-partum depression but we used it to evaluate perinatal depression as it is also validated for antenatal depression measurement. Patients were divided into two groups based on EDPS score, the study group contained patients at high risk of antenatal depression with a score of 10 ≤, and the comparison group contained women at low risk of depression with a score <10. Data analysis was done by SPSS version 24.0. Results: The frequency of preterm delivery was significantly higher in the study group with 40% preterm births and 23.4% early preterm births as compared to 19.1% and 12.4% in the comparison group, respectively. Similarly, birthweight was lower in the study group (40%) and low 1-minute (20%) and 5-minute Apgar scores. Multivariate regression analysis revealed an independent and significant relationship between maternal depression and preterm delivery (aOR: 3.27, 95% CI: 1.23-9.47) (p=0.030). However, no independent association was found between NICU admission and antenatal depression (aOR: 3.1, 95% CI: 1.0-5.2) (p=0.087) and risk of C-section (aOR: 0.9, 95% CI: 0.9-1.9) (p=0.731). Conclusions: Antepartum depression was a frequent condition among hospitalized pregnant women independently correlated to preterm births. Depression screening of pregnant women was recommended to prevent adverse maternal and neonatal outcomes.
References
Liu X, Wang S, Wang G. Prevalence and risk factors of postpartum depression in women: A systematic review and meta‐analysis. Journal of Clinical Nursing. 2022 Oct; 31(19-20): 2665-77. doi: 10.1111/jocn.16121.
Maria de Jesus Silva M, Santos Lima G, Cristina dos Santos Monteiro J, José Clapis M. Depressão na gravidez: fatores de risco associados à sua ocorrência. SMAD Revista Electronica Salud Mental, Alcohol y Drogas. 2020 Jan; 16(1). doi: 10.11606/issn.1806-6976.smad.2020.153332.
Zhang L, Yang X, Zhao J, Zhang W, Cui C, Yang F et al. Prevalence of prenatal depression among pregnant women and the importance of resilience: a multi-site questionnaire-based survey in Mainland China. Frontiers in Psychiatry. 2020 May; 11: 374. doi: 10.3389/fpsyt.2020.00374.
Dowse E, Chan S, Ebert L, Wynne O, Thomas S, Jones D et al. Impact of perinatal depression and anxiety on birth outcomes: a retrospective data analysis. Maternal and Child Health Journal. 2020 Jun; 24: 718-26. doi: 10.1007/s10995-020-02906-6.
Ribeiro GD, Cieto JF, Silva MM. Risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de alto risco. Revista da Escola de Enfermagem da USP. 2022 Jul; 56: e20210470. doi: 10.1590/1980-220x-reeusp-2021-0470en.
Ghimire U, Papabathini SS, Kawuki J, Obore N, Musa TH. Depression during pregnancy and the risk of low birth weight, preterm birth and intrauterine growth restriction-an updated meta-analysis. Early Human Development. 2021 Jan; 152: 105243. doi: 10.1016/j.earlhumdev.2020.105243.
Levis B, Negeri Z, Sun Y, Benedetti A, Thombs BD. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. British Medical Journal. 2020 Nov; 371. doi: 10.1136/bmj.m4022.
Tanuma-Takahashi A, Tanemoto T, Nagata C, Yokomizo R, Konishi A, Takehara K et al. Antenatal screening timeline and cutoff scores of the Edinburgh Postnatal Depression Scale for predicting postpartum depressive symptoms in healthy women: a prospective cohort study. BioMed Central Pregnancy and Childbirth. 2022 Jun; 22(1): 527. doi: 10.1186/s12884-022-04740-w.
Park SH and Kim JI. Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 2023 May; 307(5): 1331-45. doi: 10.1007/s00404-022-06525-0.
Lyubenova A, Neupane D, Levis B, Wu Y, Sun Y, He C et al. Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta‐analysis. International Journal of Methods in Psychiatric Research. 2021 Mar; 30(1): e1860. doi: 10.1002/mpr.1860.
Atif M, Halaki M, Raynes‐Greenow C, Chow CM. Perinatal depression in Pakistan: A systematic review and meta‐analysis. Birth. 2021 Jun; 48(2): 149-63. doi: 10.1111/birt.12535.
Manso-Martínez ME, Esteban-Gonzalo L, Marazuela-López B, García-Luengo A, De-La-Torre-Gallego A, González-Pascual JL. Variability of the Edinburgh Postnatal Depression Scale for Antenatal Depression Screening in Spanish: a Cross-Sectional Study. 2020.
Sade S, Sheiner E, Wainstock T, Hermon N, Yaniv Salem S, Kosef T et al. Risk for depressive symptoms among hospitalized women in high-risk pregnancy units during the COVID-19 pandemic. Journal of Clinical Medicine. 2020 Jul; 9(8): 2449. doi: 10.3390/jcm9082449.
Smorti M, Ginobbi F, Simoncini T, Pancetti F, Carducci A, Mauri G et al. Anxiety and depression in women hospitalized due to high-risk pregnancy: An integrative quantitative and qualitative study. Current Psychology. 2023 Mar; 42(7): 5570-9. doi: 10.1007/s12144-021-01902-5.
Tsakiridis I, Dagklis T, Zerva C, Mamopoulos A, Athanasiadis A, Papazisis G. Depression in pregnant women hospitalized due to intrauterine growth restriction: prevalence and associated factors. Midwifery. 2019 Mar; 70: 71-5. doi: 10.1016/j.midw.2018.12.008.
Toscano M, Royzer R, Castillo D, Li D, Poleshuck E. Prevalence of depression or anxiety during antepartum hospitalizations for obstetric complications: A systematic review and meta-analysis. Obstetrics & Gynecology. 2021 May; 137(5): 881-91. doi: 10.1097/AOG.0000000000004335.
Fransson E, Sörensen F, Kallak TK, Ramklint M, Eckerdal P, Heimgärtner M, et al. Maternal perinatal depressive symptoms trajectories and impact on toddler behavior–the importance of symptom duration and maternal bonding. Journal of affective disorders. 2020 Aug 1; 273:542-51. https://doi.org/10.1016/j.jad.2020.04.003
Sachdeva J, Yang SN, Gopalan P, Worley LL, Mittal L, Shirvani N et al. Trauma informed care in the obstetric setting and role of the perinatal psychiatrist: A comprehensive review of the literature. Journal of the Academy of Consultation-Liaison Psychiatry. 2022 Sep; 63(5): 485-96. doi: 10.1016/j.jaclp.2022.04.005.
Fekadu Dadi A, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: a systematic review and meta-analysis. PLOS One. 2020 Jan; 15(1): e0227323. doi: 10.1371/journal.pone.0227323.
Thiel F, Pittelkow MM, Wittchen HU, Garthus-Niegel S. The relationship between paternal and maternal depression during the perinatal period: a systematic review and meta-analysis. Frontiers in Psychiatry. 2020 Oct; 11: 563287. doi: 10.3389/fpsyt.2020.563287.
Jahan N, Went TR, Sultan W, Sapkota A, Khurshid H, Qureshi IA et al. Untreated depression during pregnancy and its effect on pregnancy outcomes: a systematic review. Cureus. 2021 Aug; 13(8). doi: 10.7759/cureus.17251.
Blanc J, Rességuier N, Lorthe E, Goffinet F, Sentilhes L, Auquier P et al. Association between extremely preterm caesarean delivery and maternal depressive and anxious symptoms: a national population‐based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2021 Feb; 128(3): 594-602. doi: 10.1111/1471-0528.16499.
Al Rawahi A, Al Kiyumi MH, Al Kimyani R, Al-Lawati I, Murthi S, Davidson R et al. The effect of antepartum depression on the outcomes of pregnancy and development of postpartum depression: a prospective cohort study of Omani women. Sultan Qaboos University Medical Journal. 2020 May; 20(2): e179. doi: 10.18295/squmj.2020.20.02.008.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments