A Meta-analysis of Depression During Pregnancy and the Risk of Preterm Birth, Low Birth Weight, and Intrauterine Growth Restriction

Abstract

Preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IUGR) are the leading causes of neonatal, infant, and childhood morbidity, mortality, and neurodevelopmental impairments and disabilities worldwide.^1-5 Maternal depression during pregnancy has begun to be recognized as a factor that may adversely alter pregnancy outcomes.^6-8 Depression also has been linked to known risk factors for adverse pregnancy outcomes such as smoking,^9,10 substance abuse,¹¹ hypertension,^12,13 preeclampsia,^14,15 and gestational diabetes.^16,17 Recent estimates of the prevalence of major depression during pregnancy show that from 8.3%¹⁸ to 12.7%¹⁹ of US women experience this condition. Moreover, many community-based studies have indicated that poor urban women from minority backgrounds^20-22 are at least twice as likely as middle-class women^23-25 to meet diagnostic criteria for major and minor depression during pregnancy and the postpartum period (20%-25% vs 9%-13%, respectively). These findings are congruent with epidemiological data showing higher rates of depression in poor young women²⁶ and with data on prevalence rates of perinatal depression for women in developing countries.^27-29