Impact of a high Edinburgh Postnatal Depression Scale score on obstetric and perinatal outcomes

The aim of this retrospective study was to characterise intrapartum and neonatal outcomes in women with an antenatally recorded Edinburgh Postnatal Depression Score (EPDS) ≤ 9 compared with women with a score of ≥12 at a major Australian tertiary maternity hospital. Women with scores ≥12 are at particularly high risk of major depressive symptomatology. There were 20512 (78.6%) women with a score ≤ 9 and 2708 (10.4%) had a score ≥ 12. Category 1 caesarean sections where there was immediate threat to life (maternal or fetal) were more common in women with EPDS scores ≥12 (5.2% vs. 4.3%, OR 1.24 95% CI 1.03-1.49, p = 0.024). Pre-term birth (<37 weeks) was also more common (11.7% vs. 8.6%, OR 1.38 95% CI 1.21-1.57, p < 0.001). Women with high scores had higher rates of babies with birth weights <5^th centile (6.2% vs. 4.4%, p < 0.001). Apgar score < 7 at 5 minutes were more frequent in the high EPDS group (3.1% vs. 2%, OR 1.52 95% CI 1.18-1.93, p < 0.001). Resuscitation at birth (34.4% vs. 30.6%, p < 0.001) and neonatal death (0.48% vs. 0.13%, OR 2.52 95% CI 1.2-5.0, p < 0.001) were higher in babies of these women. These results suggest poorer intrapartum and neonatal outcomes for women with high EPDS scores.