Overview of antenatal depression

Approximately 10% of pregnant individuals experience depression. In Australia, suicide is a leading cause of death during the perinatal period, exceeding causes of death directly related to childbirth or its complications. Although reducing psychotropic effects on the fetus is important, it is equally important not to undertreat depression during pregnancy because of increased risk of suicide and other adverse obstetric and neonatal outcomes.

During pregnancy, people with depression are more likely to report pain, gastrointestinal symptoms and dizziness, and often have comorbid anxiety; see Assessing a person with anxiety and Considerations in managing anxiety disorders during the perinatal period. They generally have lower attendance at antenatal appointments; poorer nutrition; higher rates of smoking, alcohol and illicit drug use; and are less likely to take vitamin and mineral supplements. Antenatal depression is the most important risk factor for postnatal depression—see also Preventing postnatal depression.

Antenatal depression is associated with miscarriage, preterm birth, increased neonatal cortisol concentration at birth, low neonatal birthweight, smaller neonatal head circumference and poor neonatal adaptation. These associations make it difficult to determine if obstetric and neonatal complications are attributable to depression during pregnancy or the drugs used to treat it.