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Antenatal depression: Pregnancy and neonatal outcomes

Sophie Grigoriadis, MD, MA, PhD, FRCPC
Section Editors
Peter P Roy-Byrne, MD
Charles J Lockwood, MD, MHCM
Deputy Editor
David Solomon, MD


Antenatal maternal depression is associated with adverse effects upon pregnancy and neonatal outcomes [1-3]. In addition, prenatal depression is associated with abnormal infant and child development, as well as cognitive problems and psychopathology in the offspring.

This topic reviews the association between antenatal depression and pregnancy and neonatal outcomes. The association of antenatal depression with abnormal child development, as well as cognitive impairment and psychopathology in the offspring, are discussed separately, as are the risks of prenatal antidepressants, and the clinical features, assessment, diagnosis, and treatment of antenatal depression:

(See "Antenatal depression: Risks of abnormal infant and child development".)

(See "Antenatal depression: Risks of cognitive impairment and psychopathology in the offspring".)

(See "Risks of antidepressants during pregnancy: Selective serotonin reuptake inhibitors (SSRIs)".)


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Literature review current through: Sep 2016. | This topic last updated: Jul 14, 2016.
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  1. Grigoriadis S, VonderPorten EH, Mamisashvili L, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013; 74:e321.
  2. Pearlstein T. Depression during Pregnancy. Best Pract Res Clin Obstet Gynaecol 2015; 29:754.
  3. National Institute for Health and Care Excellence (NICE). Antenatal and postnatal mental health: clinical management and service guidance. NICE clinical guideline 192. December 2014. http://www.nice.org.uk/guidance/cg192 (Accessed on January 28, 2016).
  4. Chaudron LH. Complex challenges in treating depression during pregnancy. Am J Psychiatry 2013; 170:12.
  5. Lupattelli A, Spigset O, Koren G, Nordeng H. Risk of vaginal bleeding and postpartum hemorrhage after use of antidepressants in pregnancy: a study from the Norwegian Mother and Child Cohort Study. J Clin Psychopharmacol 2014; 34:143.
  6. Räisänen S, Lehto SM, Nielsen HS, et al. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002-2010 in Finland. BMJ Open 2014; 4:e004883.
  7. Mei-Dan E, Ray JG, Vigod SN. Perinatal outcomes among women with bipolar disorder: a population-based cohort study. Am J Obstet Gynecol 2015; 212:367.e1.
  8. Ban L, Gibson JE, West J, et al. Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study. BJOG 2014; 121:1471.
  9. Almeida ND, Basso O, Abrahamowicz M, et al. Risk of Miscarriage in Women Receiving Antidepressants in Early Pregnancy, Correcting for Induced Abortions. Epidemiology 2016; 27:538.
  10. Johansen RL, Mortensen LH, Andersen AM, et al. Maternal use of selective serotonin reuptake inhibitors and risk of miscarriage - assessing potential biases. Paediatr Perinat Epidemiol 2015; 29:72.
  11. Malm H, Sourander A, Gissler M, et al. Pregnancy Complications Following Prenatal Exposure to SSRIs or Maternal Psychiatric Disorders: Results From Population-Based National Register Data. Am J Psychiatry 2015; 172:1224.
  12. Avalos LA, Chen H, Li DK. Antidepressant medication use, depression, and the risk of preeclampsia. CNS Spectr 2015; 20:39.
  13. Liu C, Cnattingius S, Bergström M, et al. Prenatal parental depression and preterm birth: a national cohort study. BJOG 2016.
  14. Palmsten K, Setoguchi S, Margulis AV, et al. Elevated risk of preeclampsia in pregnant women with depression: depression or antidepressants? Am J Epidemiol 2012; 175:988.
  15. Palmsten K, Huybrechts KF, Michels KB, et al. Antidepressant use and risk for preeclampsia. Epidemiology 2013; 24:682.
  16. Hu R, Li Y, Zhang Z, Yan W. Antenatal depressive symptoms and the risk of preeclampsia or operative deliveries: a meta-analysis. PLoS One 2015; 10:e0119018.
  17. Oberlander TF, Warburton W, Misri S, et al. Neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitor antidepressants and maternal depression using population-based linked health data. Arch Gen Psychiatry 2006; 63:898.
  18. Engelstad HJ, Roghair RD, Calarge CA, et al. Perinatal outcomes of pregnancies complicated by maternal depression with or without selective serotonin reuptake inhibitor therapy. Neonatology 2014; 105:149.
  19. Stein A, Pearson RM, Goodman SH, et al. Effects of perinatal mental disorders on the fetus and child. Lancet 2014; 384:1800.
  20. Szegda K, Markenson G, Bertone-Johnson ER, Chasan-Taber L. Depression during pregnancy: a risk factor for adverse neonatal outcomes? A critical review of the literature. J Matern Fetal Neonatal Med 2014; 27:960.
  21. Nordeng H, van Gelder MM, Spigset O, et al. Pregnancy outcome after exposure to antidepressants and the role of maternal depression: results from the Norwegian Mother and Child Cohort Study. J Clin Psychopharmacol 2012; 32:186.
  22. Kim DR, Sockol LE, Sammel MD, et al. Elevated risk of adverse obstetric outcomes in pregnant women with depression. Arch Womens Ment Health 2013; 16:475.
  23. Venkatesh KK, Riley L, Castro VM, et al. Association of Antenatal Depression Symptoms and Antidepressant Treatment With Preterm Birth. Obstet Gynecol 2016; 127:926.
  24. Grote NK, Bridge JA, Gavin AR, et al. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 2010; 67:1012.
  25. Nulman I, Koren G, Rovet J, et al. Neurodevelopment of children following prenatal exposure to venlafaxine, selective serotonin reuptake inhibitors, or untreated maternal depression. Am J Psychiatry 2012; 169:1165.
  26. Goedhart G, Snijders AC, Hesselink AE, et al. Maternal depressive symptoms in relation to perinatal mortality and morbidity: results from a large multiethnic cohort study. Psychosom Med 2010; 72:769.
  27. El Marroun H, Jaddoe VW, Hudziak JJ, et al. Maternal use of selective serotonin reuptake inhibitors, fetal growth, and risk of adverse birth outcomes. Arch Gen Psychiatry 2012; 69:706.
  28. Accortt EE, Cheadle AC, Dunkel Schetter C. Prenatal depression and adverse birth outcomes: an updated systematic review. Matern Child Health J 2015; 19:1306.
  29. Gentile S. Untreated depression during pregnancy: Short- and long-term effects in offspring. A systematic review. Neuroscience 2015.
  30. Chang HY, Keyes KM, Lee KS, et al. Prenatal maternal depression is associated with low birth weight through shorter gestational age in term infants in Korea. Early Hum Dev 2014; 90:15.
  31. Figueiredo B, Canário C, Field T. Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression. Psychol Med 2014; 44:927.
  32. Pearson RM, Evans J, Kounali D, et al. Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years. JAMA Psychiatry 2013; 70:1312.
  33. Şahingöz M, Yuksel G, Karsidag C, et al. Birth weight and preterm birth in babies of pregnant women with major depression in relation to treatment with antidepressants. J Clin Psychopharmacol 2014; 34:226.