Association Between Antenatal Depression Symptom Trajectories and Preterm Birth

Area of Science:

• Obstetrics and Gynecology
• Perinatal Mental Health
• Reproductive Psychiatry

Background:

• Antenatal depression is a significant concern during pregnancy.
• Mental health care access for pregnant individuals is crucial for maternal and fetal outcomes.
• Preterm birth remains a leading cause of neonatal morbidity and mortality.

Purpose of the Study:

• To investigate the association between the trajectory of antenatal depression symptoms and the incidence of preterm birth.
• To determine if improvement in depression symptoms during pregnancy impacts preterm birth risk.
• To evaluate the effectiveness of perinatal collaborative mental health care.

Main Methods:

• Retrospective cohort study of pregnant individuals referred to a perinatal collaborative care program.
• Depression symptoms monitored using Patient Health Questionnaire-9 (PHQ-9) scores.
• Antenatal depression trajectories (improved, stable, worsened) analyzed in relation to preterm birth rates, controlling for confounders using propensity scores.

Main Results:

• A significant association was found between antenatal depression symptom trajectories and preterm birth (P =.009).
• Pregnant individuals with improved depression symptoms had a 63% lower odds of preterm birth compared to those with worsened symptoms (aOR 0.37, 95% CI 0.15-0.89).
• The incidence of preterm birth was 12.5% for improved, 14.0% for stable, and 30.8% for worsened depression symptom trajectories.

Conclusions:

• An improved antenatal depression symptom trajectory is associated with decreased odds of preterm birth.
• Integrating mental health care into routine obstetric services is vital for public health.
• Effective management of antenatal depression may contribute to reducing preterm birth rates.