A prospective cohort study to assess the prevalence and risk factors of antepartum depression and its effect on maternal and fetal outcome

Abstract

Antepartum depression (APD) is a public health issue has negative repercussions on the health of the mother, child, and family. Early screening for APD will help in early detection and further prevention of postpartum depression and adverse maternal and fetal outcomes. This study was designed to determine i) the prevalence rate of APD in the Indian population and its associated risk factors, ii) the impact of APD on maternal and fetal outcomes. A retrospective cohort study was conducted among antenatal women in the third trimester and screened for antepartum depression between October 2021 and March 2022 by adopting the Edinburgh Postnatal Depression Scale (EPDS). In the study population, 36.6 % had mild to moderate level of depressive symptoms (EPDS score of 8-12) and 28 % had high levels of depressive symptoms (EPDS score of ≥13). An unplanned pregnancy, a history of abortion, and a history of any pregnancy complications were the likely maternal risk factors for developing antepartum depression. The APD risk was also likely to be increased by sociodemographic and personal factors such as insufficient family support, a history of domestic violence, marital dissatisfaction, and a partner with a poor level of education (P < 0.05). Women screened with antepartum depression had 58.34 times the likelihood of developing postpartum depression and a threefold greater risk of having premature delivery. These findings may help to improve pregnancy outcomes by early identification, referral for early treatment of antepartum depression, also inform maternal mental health service development and utilization for boosting women's mental wellbeing.

Keywords: Antepartum depression; Postpartum depression; Risk factors of antepartum depression.