Depressive symptoms during pregnancy linked to slower fetal growth rates

Key takeaways:

• Higher depressive scores during pregnancy were correlated with slower fetal growth rate.
• Women in the highest vs. lowest depressive quintile had decreased fetal growth rates from weeks 30 to 37 gestational weeks.

Among women in China, depressive symptoms during pregnancy were associated with slower fetal growth rate in the rapid growth stage during weeks 30 and 37 of gestation, according to study findings published in JAMA Network Open.

“As far as we know, there is a paucity of evidence utilizing longitudinal measurements during the critical rapid growth stage before delivery to explore the potential association between maternal depressive symptoms and fetal growth,” Lu Zhang, MPH, from the department of maternal and child health, child and adolescent health and the Institute of Systems Epidemiology at West China School of Public Health and West China Fourth Hospital at Sichuan University, China, and colleagues wrote in findings published in JAMA Network Open. “Moreover, it is important to acknowledge the substantial racial and ethnic variations in fetal growth. Unfortunately, most existing studies were conducted in Western countries, thus restricting the generalizability of these findings to East Asia.”

Zhang and colleagues conducted a prospective birth cohort study from 2018 to 2020 with 2,676 mother-offspring pairs. All mothers (mean age, 28 years) were enrolled during their first trimester of prenatal visits from 13 hospitals in 81 counties across 12 cities in Sichuan, China. Maternal depressive symptoms were measured by the Edinburgh Postpartum Depression Scale (EPDS) at a median of 24 gestational weeks with higher scores indicating worse depressive symptoms. All women attended follow-up visits during their second trimester, third trimester and 24 hours after delivery.

The primary outcomes were ultrasonography-measured biparietal diameter, femur length and abdominal circumference and estimated fetal weight. Researchers evaluated these parameters during gestational weeks 30 and 37.

The median maternal EPDS score was 5. When adjusting for confounders, researchers observed a significant correlation between a higher EPDS score for mothers and a slower fetal growth rate across femur length (beta = –0.4), abdominal circumference (beta = –1.97) and estimated fetal weight (beta = –50.11). Fetuses of mothers in the highest quintile of depressive status had significantly decreased growth rates from weeks 30 to 37 gestational weeks compared with mothers in the lowest quintile.

Researchers noted that these associations were strongest for female fetuses or mothers with better family socioeconomic conditions.

“These findings underscore the importance of early detection and management of maternal depressive symptoms during pregnancy, particularly among women with higher socioeconomic status or female fetuses,” the researchers wrote.