The effect of antenatal screening for depression on neonatal birthweight and gestation

Abstract

Background: Antenatal depression has been associated with poor perinatal outcomes such as preterm birth and low birth weight. Universal screening of perinatal depression has been recommended to improve maternal and pregnancy outcomes.

Hypothesis and aim: We hypothesise that screening for antenatal depressive symptoms may reduce the risk of preterm birth and low birth weight. To assess the hypothesis, we explore the association between antenatal depression screening using the Edinburgh Postnatal Depression Scale and neonatal outcomes.

Methods: A retrospective analysis of state-wide population-based health administrative data. Inclusion criteria were pregnant women who gave birth to a singleton in Queensland in the second half of 2015 (29,543 women). Logistic regression analyses were run in 27,817 women with information in all variables. Main outcomes were preterm birth (<37 weeks of gestation) and low birth weight (<2500 grs).

Results: Women who did not complete the screening had increased odds of preterm birth (AOR, 1.56; 95% CI, 1.39-1.74; p < 0.001) and low birth weight (AOR, 1.48; 95% CI, 1.30-1.68; p < 0.001) before and after adjustments for relevant confounders when compared to women who completed the screening. Sensitivity analyses performed in women with spontaneous labour and in women without a diagnosis of depression showed similar results.

Conclusion(s): We found an association between screening for depressive symptoms during pregnancy and better neonatal outcomes. However, this result does not necessarily infer causality. Any association may represent a previously unknown benefit to screening, which could support the case for universal antenatal depression screening.

Keywords: Antenatal; EPDS; Edinburgh postnatal depression scale; LBW; Low birth weight; PTB; Pregnancy; Premature birth; Preterm.