Risk of adverse maternal outcomes associated with prenatal exposure to moderate-severe depression compared with mild depression: A fellow-up study

Background: Pregnancy is a time of increased vulnerability for the development of anxiety and depression. The purpose of this study was to compare the risk of developing adverse maternal and perinatal outcomes between pregnant women with moderate-severe depression and those who had mild depression. Methods: Our study was performed in a prospective cohort of 360 depressed pregnant women, recruited and followed up to delivery at the Adventist Hospital in Bekwai Municipality, Ghana. The research began in February 2020 and the follow-up was completed in August 2020. The pregnant women who had depression were classified into two groups: those who had moderate-severe depression (Patient Health Questionnaires-9 (PHQ-9) score ?15) and those who had mild depression (PHQ-9 score <15). Crude and adjusted relative risk (RR) with their corresponding 95% confidence intervals (95% CIs) for women with moderate-severe depression as compared with women with mild depression were then estimated. Result: Out of a total of 360 pregnant women, 43 (11.9%) screened positive for moderate-severe depression. After adjusting for potential confounders, women with moderate-severe depression during pregnancy, as compared with women who had mild depression had an increased risk of pre-eclampsia (RR adjusted = 2.01; 95% CI:1.21?3.33); Caesarean section (RR adjusted = 1.78; 95% CI:1.18?2.70); and episiotomy (RR adjusted = 1.66; 95% CI: 1.06?2.60). On the other hand, no statistically significant association of severity of depression and perinatal outcomes was observed. Conclusion: Compared with mild depression, symptoms of moderate-severe depression in pregnancy significantly increased risks of adverse maternal outcomes such as pre-eclampsia, caesarean section delivery, and episiotomy.