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Cited by 1,882Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

A Meta-analysis of Depression During Pregnancy and the Risk of Preterm Birth, Low Birth Weight, and Intrauterine Growth Restriction

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Grote, Nancy K., Bridge, Jeffrey A., Gavin, Amelia R., Melville, Jennifer L., Iyengar, Satish, Katon, Wayne J.·2010·Archives of General Psychiatry
DOI 10.1001/archgenpsychiatry.2010.111PMC PMC3025772
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Abstract

CONTEXT: Maternal depressive symptoms during pregnancy have been reported in some, but not all, studies to be associated with an increased risk of preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IUGR). OBJECTIVE: To estimate the risk of PTB, LBW, and IUGR associated with antenatal depression. DATA SOURCES AND STUDY SELECTION: We searched for English-language and non-English-language articles via the MEDLINE, PsycINFO, CINAHL, Social Work Abstracts, Social Services Abstracts, and Dissertation Abstracts International databases (January 1980 through December 2009). We aimed to include prospective studies reporting data on antenatal depression and at least 1 adverse birth outcome: PTB (<37 weeks' gestation), LBW (<2500 g), or IUGR (<10th percentile for gestational age). Of 862 reviewed studies, 29 US-published and non-US-published studies met the selection criteria. DATA EXTRACTION: Information was extracted on study characteristics, antenatal depression measurement, and other biopsychosocial risk factors and was reviewed twice to minimize error. DATA SYNTHESIS: Pooled relative risks (RRs) for the effect of antenatal depression on each birth outcome were calculated using random-effects methods. In studies of PTB, LBW, and IUGR that used a categorical depression measure, pooled effect sizes were significantly larger (pooled RR [95% confidence interval] = 1.39 [1.19-1.61], 1.49 [1.25-1.77], and 1.45 [1.05-2.02], respectively) compared with studies that used a continuous depression measure (1.03 [1.00-1.06], 1.04 [0.99-1.09], and 1.02 [1.00-1.04], respectively). The estimates of risk for categorically defined antenatal depression and PTB and LBW remained significant when the trim-and-fill procedure was used to correct for publication bias. The risk of LBW associated with antenatal depression was significantly larger in developing countries (RR = 2.05; 95% confidence interval, 1.43-2.93) compared with the United States (RR = 1.10; 95% confidence interval, 1.01-1.21) or European social democracies (RR = 1.16; 95% confidence interval, 0.92-1.47). Categorically defined antenatal depression tended to be associated with an increased risk of PTB among women of lower socioeconomic status in the United States. CONCLUSIONS: Women with depression during pregnancy are at increased risk for PTB and LBW, although the magnitude of the effect varies as a function of depression measurement, country location, and US socioeconomic status. An important implication of these findings is that antenatal depression should be identified through universal screening and treated.

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  • Children exposed to maternal depression during pregnancy have a higher risk of adverse birth outcomes, such as prematurity and being small for gestational age.

    “Children who are exposed to maternal depression during pregnancy have a higher risk of adverse birth outcomes, such as prematurity and being small for gestational age.9 10”

    From Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial (2020) · cites this paper as [9]

    The Results report that antenatal depression was significantly associated with preterm birth. But the same section found no significant association with intrauterine growth restriction, an outcome that the Methods say included small-for-gestational-age studies. The source therefore supports the prematurity example but not the claimed higher risk of being small for gestational age. (LLM, conf=0.92)

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  • Prenatal depression is associated with increased risk of preterm birth, low birth weight, and being small for gestational age.

    “For the fetus, depression is associated with adverse effects through the increased risk of preterm birth, low birth weight, and for being small for gestational age (19–21).”

    From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [21]

    The Results section reports significant associations of antenatal depression with preterm birth and low birth weight. The Methods section includes small-for-gestational-age studies in its intrauterine-growth-restriction analysis, but the Results report no significant overall association with that outcome (RR=1.03; 95% CI, 0.99–1.08). (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Untreated depression during pregnancy is associated with obstetrical and neonatal complications.

    “Untreated depression during pregnancy poses risks to the mother and baby, including obstetrical and neonatal complications [3-8].”

    From Complementary and alternative medicine therapies for perinatal depression (2014) · cites this paper as [7]

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  1. [76]First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview for DSM-IV Axis I Disorders: SCID-I—Clinician Version Washington, DC American Psychiatric Press 1997

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Authors
Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., & Katon, W. J.
Affiliations
  • University of Pittsburgh (US)
  • Nationwide Children's Hospital (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2010-10-04
Volume
67
Issue
10
Pages
1012
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archgenpsychiatry.2010.111
PMC
PMC3025772
OpenAlex
W2150504996
Cited by
1,882
References
171
Citations by year
2026: 64 · 2025: 104 · 2024: 87 · 2023: 128 · 2022: 156 · 2021: 159 · 2020: 212 · 2019: 135 · 2018: 143 · 2017: 115 · 2016: 109 · 2015: 137 · 2014: 113 · 2013: 116 · 2012: 72
FWCI
9.89
Type
journal article
Language
en
Open access
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5k23mh070704-05, 5kl2rr025015-02)
  • National Institute of Mental Health (K23MH067595, K24MH069471, R01MH085668, K23 MH070704, K01MH069948)
  • National Center for Research Resources (KL2-RR025015, 1KL2-RR-025015-01)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD042828)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
antenatal depression, maternal depression, preterm birth, low birth weight, fetal growth restriction, adverse birth outcomes, publication bias, developing countries, biopsychosocial risk factors, prenatal genetic testing
MeSH terms
Cross-Cultural Comparison, Depressive Disorder, Female, Fetal Growth Retardation, Humans, Infant, Low Birth Weight, Infant, Newborn, Obstetric Labor, Premature, Mass Screening, Pregnancy, Pregnancy Complications, Prospective Studies, Risk, Socioeconomic Factors

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