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Antenatal depressive symptoms and preterm birth: a prospective study of a Swedish national sample.

BACKGROUND
Preterm birth is the principal risk factor for neonatal morbidity and mortality. The objective of this study was to investigate the association between antenatal depressive symptoms and preterm birth.


METHODS
The study included a national sample of 2,904 pregnant women who were recruited at their first booked visit to antenatal clinics in Sweden. Data on depressive symptoms, and sociodemographic and reproductive background were collected by questionnaires. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS). The average length of gestation at the time for completion of the questionnaire was 16 weeks. Data on gestational length were extracted from the Swedish Medical Birth Register. Multiple logistic regression analyses were conducted to estimate the risk of preterm birth associated with antenatal depressive symptoms.


RESULTS
The presence of antenatal depressive symptoms above a cutoff score of 12 or higher on the EPDS increased the risk for preterm birth (OR: 1.56; 95% CI: 1.03-2.35). Being of age 35 years and over, being a primipara, and having experienced a previous miscarriage were also shown to be significant predictors in a multivariate model.


CONCLUSION
Pregnant women reporting antenatal depressive symptoms are at elevated risk of preterm birth.