Objective: To examine if depressive symptomatology in pregnancy is associated with adverse obstetric and neonatal outcomes.

Method: In a prospective observational study, 959 women were followed up longitudinally from early pregnancy to postpartum. The level of depression was measured at baseline (first antepartum visit) and in late pregnancy using the Beck Depression Inventory (BDI). Adverse obstetric and neonatal outcomes were recorded at delivery.

Results: Depression in late pregnancy was associated with increased risk of epidural analgesia (33% vs. 19%, p=0.01, adjusted RR=2.56, 95% CI 1.24-5.30), operative deliveries (Cesarean sections and instrumental vaginal deliveries) (39% vs. 27%, p=0.02, adjusted RR=2.28, 95% CI 1.15-4.53), and admission to neonatal care unit (24% vs. 19%, p=0.03, adjusted RR=2.18, 95% CI 1.02-4.66). These effects remained significant even when potential confounders, such as antepartum complications, were controlled for.

Conclusion: Previous studies have shown that antepartum anxiety or stress were associated with growth retardation, premature delivery and epidural analgesia. Our findings add to this body of evidence, which together suggest an adverse impact of antepartum psychological morbidity on maternal and neonatal well being.