(914) Impact of Maternal Anxiety and Depression on Perinatal Outcomes

Friday, January 31, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Sarah K. Dzubay, BS (she/her/hers)

MD-MPH student
Oregon Health & Science University
Portland, Oregon, United States

Coauthor(s)

Bharti Garg, MBBS, MPH (she/her/hers)

Biostatistician 3
Oregon Health & Science University
Portland, Oregon, United States
Aaron B. Caughey, MD, PhD

Professor and Chair
Oregon Health & Science University
Portland, Oregon, United States

Objective: To investigate whether anxiety, depression, or both anxiety and depression have differential impacts on perinatal outcomes relative to those without anxiety or depression.

Study Design: We performed a retrospective cohort study among singleton, non-anomalous births delivered at 23-42 weeks in California between 2008 and 2020. We compared perinatal outcomes between pregnant individuals without depression or anxiety to those with anxiety, depression, or both anxiety and depression. Births were excluded if the mother had bipolar disorder. We performed a multivariable Poisson regression, controlling for race/ethnicity, age, pre-pregnancy BMI, parity, insurance type, education level, and smoking during pregnancy.

Results: Of the 5,048,487 births meeting inclusion criteria, 97.12% of mothers had no anxiety or depression, 1.17% had depression, 1.25% had anxiety, and 0.47% had anxiety and depression (Table 1). Individuals with anxiety had higher risk of gestational hypertension (aIRR=1.62; 95% CI: 1.57-1.67), preeclampsia (aIRR=1.48 (1.43-1.53)), and SMM (aIRR=2.00 (1.90-2.11)); however, individuals with depression had higher risk of gestational diabetes (aIRR=1.20 (1.17-1.23) and postpartum hemorrhage (aIRR=1.77 (1.71-1.83)) (Table 2). With regards to neonatal outcomes, individuals with both depression and anxiety had higher risk of preterm birth < 37 weeks (aIRR=1.27 (1.23-1.33)), NICU admission (aIRR=1.11 (1.07-1.15)), lower Apgar scores (aIRR=2.34 (2.15-2.54)), respiratory distress syndrome (aIRR=1.65 (1.49-1.81)), hypoglycemia (aIRR=1.96 (1.83-2.09) and low birth weight (aIRR=1.15 (1.06-1.24)).

Conclusion: Individuals with anxiety, depression, or both had higher risk of maternal and neonatal outcomes relative to those without a mood disorder. Interestingly, individuals with depression or anxiety had higher risk of maternal outcomes while individuals with both depression and anxiety had higher risk for neonatal outcomes. Prenatal screening and treatment for anxiety and depression may be beneficial in protecting against adverse outcomes.