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Untreated depression increases risk for adverse neonatal outcomes

Untreated depression may increase risk for preterm birth and low birth weight, according to recent findings.

“The use of antidepressant medications during pregnancy has been increasing in the last few decades both in Europe and in the United States, with 3% to 8% of women being prescribed or having used antidepressants during pregnancy. However, since 2010, several meta-analyses examining antidepressant use during pregnancy found significantly higher risks of preterm birth and low birth weight in women with depression taking antidepressants compared with either women without depression or women with untreated depression,” Alexander Jarde, PhD, of McMaster University, Hamilton, Ontario, Canada, and colleagues wrote.

To understand the effect of untreated depression on neonatal outcomes, researchers conducted a systematic review and meta-analysis of 23 studies that assessed neonatal outcomes in women with depression who did not receive pharmacological or nonpharmacological treatments and compared them with women without depression. The final cohort included 25,663 women.

Untreated depression was associated with significantly increased risk for preterm birth (OR = 1.56; 95% CI, 1.25-1.94) and low birth weight (OR = 1.96; 95% CI, 1.24-3.1). Researchers noted a trend toward higher risks for exposure to more severe depression.

Risk for preterm birth was significantly higher in studies reporting conflicts of interest (OR = 2.5; 95% CI, 1.7-3.67), compared with studies reporting no such conflicts (OR = 1.34; 95% CI, 1.08-1.66).

“Our findings have important clinical implications for pregnant women and health care professionals because they suggest the need for more surveillance for preterm birth and small infant size, key perinatal outcomes in women with untreated depression,” the researchers wrote. “Our results also suggest methodological directions that future systematic reviews could take including examining the effect of reported conflicts of interest and potential confounding variables.” – by Amanda Oldt

Disclosure: Jarde reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.