IMPACT OF MATERNAL ANXIETY AND DEPRESSION ON BIRTH OUTCOMES: A PROSPECTIVE COHORT STUDY

Abstract

Maternal anxiety and depression are critical factors affecting birth outcomes. This prospective cohort study assessed their impact on preterm birth, low birth weight, and neonatal intensive care unit (NICU) admissions among pregnant women at Swat Medical College and affiliated hospitals in Saidu Sharif, Swat. Maternal mental health was evaluated during pregnancy using validated screening tools, including the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder (GAD-7) scale. Birth outcomes were recorded post-delivery, and multivariable logistic regression models were used to adjust for confounders such as maternal age, socio-economic status, and prenatal care access. Results indicated a substantial portion of participants experienced anxiety and/or depression during pregnancy. Maternal anxiety was associated with higher risks of preterm birth (OR 1.45, 95% CI 1.12–1.87) and NICU admissions (OR 1.62, 95% CI 1.21–2.18), while maternal depression was linked to increased risk 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). Combined anxiety and depression symptoms corresponded to the highest odds of adverse outcomes. These findings highlight the importance of maternal mental health screening in prenatal 
care. Incorporating mental health services in prenatal care programs could significantly enhance maternal and neonatal health outcomes in similar healthcare settings.