Impact of maternal depression on perinatal outcomes in hospitalized women—a prospective study

Abstract

Scarce data exists regarding the prevalence of antenatal depression in hospitalized pregnant women, and its effect on perinatal outcome. We aimed to estimate the risk of maternal depression among women hospitalized in a high-risk pregnancy department, and to evaluate its potential association with adverse perinatal outcome. A depression screening self-questionnaire-based prospective study was performed, in which hospitalized pregnant women who screened positive for depression were compared to those who screened negative. The Edinburgh Postnatal Depression Scale (EPDS) was used for antenatal depression screening. Pregnancy course and perinatal outcome were compared between the groups. A multivariate logistic regression model was constructed to control for clinically relevant confounders. During the study period, 279 women met the inclusion criteria. Among them, 28.3% (n = 79) screened positive for depression (≥ 10 points on the EPDS). In the univariate analysis, a significantly higher incidence of preterm delivery (< 37 weeks), low birthweight (< 2500 g), low Apgar scores (at 1 and 5 min), and neonatal intensive care unit (NICU) admissions were noted among the screen positive group. In the multivariate regression model, controlled for maternal age, ethnicity, gestational diabetes mellitus, preeclampsia, past preterm delivery, and gestational age upon admission, maternal antenatal depression during hospitalization was noted as an independent risk factor for preterm delivery (adjusted OR 3.32, 95%CI 1.16-9.52, p = 0.026). Maternal antenatal depression during hospitalization is very common and appears to play a significant and independent role in the prediction of preterm delivery.

Risk for Depressive Symptoms among Hospitalized Women in High-Risk Pregnancy Units during the COVID-19 Pandemic

“…Women who were hospitalized in the high-risk pregnancy units before the COVID-19 pandemic (between November 2016 and April 2017) served as the comparison group. The comparison group was composed of women who were recruited for previous study performed in the same high-risk pregnancy units [ 11 ]. High risk pregnancy was defined according to the Israeli Ministry of Health statement regarding criteria for high-risk pregnancy.…”

“…Data were collected in a cross-sectional format, at two time points. Data regarding the comparison group were collected as part of a previous prospective study that was taken in the same high-risk units [ 11 ]. The group of women which served as the “unexposed” group was available from an historic study [ 11 ], and so the sample size of this group was fixed.…”

“…Studies have demonstrated serious concerns of depressive symptoms during pregnancy, in terms of maternal morbidity and adverse neonatal outcomes [ 10 ]. Pregnant women hospitalized in a high-risk pregnancy unit are described to have fair risk for depression, varying from 27–44% [ 11 , 12 , 13 ].…”

Prenatal Attachment and Perinatal Depression: A Systematic Review

“…Several authors reported that women interacted more with the fetus as well as faced a greater risk of isolation from their families [25,73,77,138,139]. Previous studies highlighted that some of the most prevalent depressive episodes were reported by women [50,138,140,141]. Women with depressive symptoms tended to report lower caring toward the fetus [119], to become more ambivalent regarding the future baby, to express more negative comments, to dislike their bodies, and to be less involved in pregnancy [6,73,142,143].…”

Yüksek Riskli Gebelerde Anksiyete ve Depresyon ile Hemşirelik Bakım Memnuniyetinin İncelenmesi

“…Gebelikte anne ve fetüsle ilgili sağlık problemlerinin ortaya çıkması ya da risk yaratan bir komplikasyon gelişmesi ve bu sebeple hastaneye yatma, yaşanan belirsizlik, hastane ortamı, yalnızlık duygusu, iş yaşantısı ve sosyal çevreden ayrı kalma gibi nedenlerle anksiyete ve depresyonun daha da artmasına sebep olmaktadır [5,6]. Yüksek riskli gebelerde anksiyete ve depresyon prevalansı ile ilgili yapılmış çalışmalar incelendiğinde anksiyete %12-41 [7][8][9], depresyon %7-47 [7,[10][11][12] oranlarında görülmektedir.…”