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A Meta-analysis of Depression During Pregnancy and the Risk of Preterm Birth, Low Birth Weight, and Intrauterine Growth Restriction
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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 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]
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“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]
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“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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Metadata
- 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)
- 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)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 › Medicine › Pediatrics, Perinatology and Child Health › 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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