Risk factors for depressive symptoms during pregnancy: a systematic review
Open accessAbstract
The purpose of this study was to evaluate risk factors for antepartum depressive symptoms that can be assessed in routine obstetric care. We evaluated articles in the English-language literature from 1980 through 2008. Studies were selected if they evaluated the association between antepartum depressive symptoms and > or =1 risk factors. For each risk factor, 2 blinded, independent reviewers evaluated the overall trend of evidence. In total, 57 studies met eligibility criteria. Maternal anxiety, life stress, history of depression, lack of social support, unintended pregnancy, Medicaid insurance, domestic violence, lower income, lower education, smoking, single status, and poor relationship quality were associated with a greater likelihood of antepartum depressive symptoms in bivariate analyses. Life stress, lack of social support, and domestic violence continued to demonstrate a significant association in multivariate analyses. Our results demonstrate several correlates that are consistently related to an increased risk of depressive symptoms during pregnancy.
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Symptoms of depression and anxiety are exacerbated by higher levels of stress.
“Moreover, symptoms of depression and anxiety have been found to be exacerbated by higher levels of stress (13–15).”
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 [14]
The Life stress section reports an association between increased stress and depressive symptoms during pregnancy. The Maternal anxiety section links anxiety with depressive symptoms, but does not say that stress worsens anxiety. The review reports associations rather than establishing that stress exacerbates either condition; page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredExposure to traumatic stress before or during pregnancy is a significant risk factor for developing peripartum depression and anxiety and may result in less favorable outcomes for child development, family functioning, and physiological stress dysregulation.
“Exposure to (traumatic) stress before or during pregnancy is a significant risk factor for developing peripartum depression and anxiety and may result in less favorable outcomes for child development, family functioning, and physiological stress dysregulation [32–34].”
From Effectiveness of a guided ACT-based self-help resilience training for depressive symptoms during pregnancy: Study protocol of a randomized controlled trial embedded in a prospective cohort. (2020) · cites this paper as [33]
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Experimental — accuracy not yet measuredRisk factors for PND include stressful life events, history of depression, poor social support, unplanned and unwanted pregnancies, poor relationship quality, current or previous abuse, and low socioeconomic status.
“Risk factors for PND include stressful life events, history of depression, poor social support, unplanned and unwanted pregnancies, poor relationship quality, current or previous abuse, and low socioeconomic status.”
From Perinatal Depression: Challenges and Opportunities (2021) · cites this paper as [14]
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“…perinatal depression, such as partner and social support, domestic violence, obstetric complications, as well as anxiety and traumatic life events (Lancaster et al., 2010; Robertson et al., 2004; Verreault et al., 2014), should be investigated further in the context of GCMM analyses.. Researchers…”
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- Authors
- Lancaster, C. A., Gold, K. J., Flynn, H. A., Yoo, H., Marcus, S. M., & Davis, M. M.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Lancaster, Christie A.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 202
- Issue
- 1
- Pages
- 5-14
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC2919747
- OpenAlex
- W2146150050
- Cited by
- 1,208
- References
- 74
- Citations by year
- 2026: 52 · 2025: 54 · 2024: 47 · 2023: 66 · 2022: 105 · 2021: 104 · 2020: 134 · 2019: 102 · 2018: 76 · 2017: 70 · 2016: 73 · 2015: 75 · 2014: 74 · 2013: 68 · 2012: 55
- FWCI
- 4.86
- Type
- journal article
- Language
- en
- Update notices
- erratum (2011-09-01)
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH085882)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD001438)
- 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 › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- antenatal depression, depressive symptoms in pregnancy, risk factors, maternal anxiety, life events, social support, domestic violence, unintended pregnancy, Medicaid, low income, smoking, marital quality, history of depression
- MeSH terms
- Anxiety, Depression, Female, Humans, Life Change Events, Pregnancy, Prenatal Care, Risk Factors, Social Class, Social Support, Stress, Psychological
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