Language-Related Differences in Prenatal Depression Screening Uptake in the USA Midwest, 2019-2024

Prenatal depression is a substantial contributor to maternal morbidity, and screening is an entry point to psychiatric assessment and treatment during pregnancy. Following updated guidelines and quality metrics for prenatal depression screening, we evaluated whether screening uptake differed by preferred language within a large USA healthcare system. We used electronic health record data to identify a retrospective cohort of deliveries at or beyond 20 weeks gestation in 2019-2024. We used logistic regression with a language×year interaction to estimate the adjusted marginal probabilities of screening by language preference. Among 92 063 pregnancies (77 828 individuals), screening increased substantially over time, but increases differed across language groups (p < 0.001). In 2019, screening probabilities were similar (English 0.50, Spanish 0.51, another language 0.46). By 2024, probabilities diverged (English 0.82, Spanish 0.72, another language 0.65). Unequal screening uptake can systematically underidentify prenatal depression among patients with non-English-language preference, with implications for equitable access to psychiatric care.