Antenatal depressive symptoms increase the likelihood of preterm birth

OBJECTIVE: We evaluated the relationship between antenatal depressive symptoms and preterm birth. STUDY DESIGN: Patients completed the Edinburgh Postnatal Depression Scale between 24-28 weeks of gestation. A score >= 12 (or thoughts of self-harm) indicated an at-risk woman. Symptomatic women were compared to risk-negative patients for relevant demography, historical variables, and pregnancy outcome. RESULTS: After screening 14,175 women we found a screen positive rate of 9.1% (n = 1298). At-risk women had a significant increase in preterm birth at <37, <34, <32, and <28 weeks of gestation. Multi-variable analysis adjusting for maternal age, race/ethnicity, prior preterm delivery, and insurance status revealed a persistent association between antenatal depressive symptoms and preterm birth (adjusted odds ratio, 1.3; 95% confidence interval, 1.09-1.35), which was also observed after multiple gestations were excluded from the analysis (odds ratio, 1.7; 95% confidence interval, 1.38-1.99). CONCLUSION: In this large cohort of prenatally screened women, those with depressive symptoms had an increased likelihood of preterm birth.