ASSOCIATION BETWEEN MATERNAL ANXIETY, DEPRESSION, AND BIRTH OUTCOMES: EVIDENCE FROM A PROSPECTIVE COHORT STUDY

Abstract

Maternal anxiety and depression are significant determinants of adverse birth outcomes. This prospective cohort study examined their influence on preterm birth, low birth weight, and neonatal intensive care unit (NICU) admissions among pregnant women attending Swat Medical College and its affiliated hospitals in Saidu Sharif, Swat. Maternal mental health was assessed during pregnancy using validated instruments, including the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder (GAD-7) scale. Birth outcomes were documented post-delivery, and multivariable logistic regression analyses were conducted to control for potential confounders such as maternal age, socioeconomic status, and access to prenatal care. Findings revealed that a notable proportion of participants experienced anxiety and/or depression during pregnancy. Maternal anxiety was significantly associated with an increased risk of preterm birth (OR = 1.45; 95% CI: 1.12–1.87) and NICU admissions (OR = 1.62; 95% CI: 1.21–2.18), whereas maternal depression was linked to higher risks of low birth weight (OR = 1.53; 95% CI: 1.20–1.96) and preterm birth (OR = 1.47; 95% CI: 1.14–1.89). The co-occurrence of anxiety and depression was associated with the greatest likelihood of adverse neonatal outcomes. These results underscore the critical need for integrating maternal mental health screening and support into routine prenatal care. Strengthening mental health services within antenatal programs could substantially improve both maternal and neonatal health outcomes in comparable healthcare contexts.