The Role of Maternal Depression in Racial Disparities and Birth Weight

Pregnant people experiencing major depression during pregnancy are at increased risk for premature labor and infants with low birth weight, and there are significant racial disparities in these outcomes. Black women are at higher risk for having premature and low birth weight infants relative to their White counterparts. As such, we sought to examine the relationships between race, depression, and obstetric outcomes (low birth weight and prematurity) in both Black and White women with live births.

This study included 185 pregnant women receiving behavioral health services within an Ob/Gyn clinic in an academic medical center in South Carolina. Main and interactive effects on birth weight and gestational age were evaluated with analysis of covariance controlling for maternal age.

The association between race and low birth weight was driven primarily by maternal depression. Infants of depressed Black women had significantly reduced birth weight relative to infants of depressed White women, but there was no evidence of racial disparities in birth weight among non-depressed Black women compared to non-depressed White women. Depression symptom severity was not associated with birth outcomes, and there was no effect of depression or race on prematurity.

The occurrence of depression during pregnancy may in part account for racial disparities in infant birth weight. Interventions to reduce depression across birthing persons but especially among Black women may be a promising direction to address racial disparities in low birth weight.