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Published on: June 13, 2021
Prenatal parental depression and preterm birth: a national cohort study
C Liu1,2, S Cnattingius2, M Bergström1
1Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, Stockholm, Sweden.
Insights
New paternal and maternal prenatal depression increase preterm birth risk. Addressing parental mental health is crucial for preventing preterm births and improving infant outcomes.
Area of Science:
- Reproductive Health
- Perinatal Mental Health
- Obstetrics
Background:
- Maternal depression is a known risk factor for preterm birth.
- The impact of paternal depression on pregnancy outcomes is less understood.
- Prenatal depression in either parent can affect fetal development and birth timing.
Purpose of the Study:
- To examine the association between maternal and paternal prenatal depression and the risk of preterm birth.
- To differentiate the risks associated with new-onset versus recurrent parental depression.
- To inform strategies for preterm birth prevention by considering parental mental health.
Main Methods:
- A national cohort study utilizing the Swedish Medical Birth Register (2007-2012).
- Included 366,499 singleton births with linked parental prescription and hospital care data.
- Defined prenatal depression based on antidepressant prescriptions or depression-related hospital care from 12 months pre-conception to 24 weeks post-conception.
Main Results:
- New paternal prenatal depression was linked to a higher risk of very preterm birth (adjusted OR 1.38).
- Both new and recurrent maternal prenatal depression were associated with increased risk of moderately preterm birth (aORs 1.34 and 1.42, respectively).
- Recurrent paternal depression did not show a significant association with preterm birth risk.
Conclusions:
- Prenatal depression in both mothers and fathers represents a significant risk factor for preterm birth.
- Early identification and management of mental health issues in both parents are vital for preterm birth prevention.
- Comprehensive perinatal care should include assessment and support for parental mental well-being.
Objective:
To investigate the effects of maternal and paternal depression on the risk for preterm birth.
Design:
National cohort study.
Setting:
Medical Birth Register of Sweden, 2007-2012.
Population:
A total of 366 499 singleton births with linked information for parents' filled drug prescriptions and hospital care.
Methods:
Prenatal depression was defined as having filled a prescription for an antidepressant drug or having been in outpatient or inpatient hospital care with a diagnosis of depression from 12 months before conception until 24 weeks after conception. An indication of depression after 12 months with no depression was defined as 'new depression', whereas all other cases were defined as 'recurrent depression'.
Main Outcome Measures:
Odds ratios (ORs) for very preterm (22-31 weeks of gestation) and moderately preterm (32-36 weeks of gestation) births were estimated using multinomial logistic regression models.
Results:
After adjustment for maternal depression and sociodemographic covariates, new paternal prenatal depression was associated with very preterm birth [adjusted OR (aOR) 1.38, 95% confidence interval (95% CI) 1.04-1.83], whereas recurrent paternal depression was not associated with an increased risk of preterm birth. Both new and recurrent maternal prenatal depression were associated with an increased risk of moderately preterm birth (aOR 1.34, 95% CI 1.22-1.46, and aOR 1.42, 95% CI 1.32-1.53, respectively).
Conclusions:
New paternal and maternal prenatal depression are potential risk factors for preterm birth. Mental health problems in both parents should be addressed for the prevention of preterm birth.
Tweetable Abstract:
Depression in both mothers and fathers is associated with an increased risk of preterm birth.
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