title: The Impact of Antenatal Depression on Perinatal Outcomes in Australian Women.
abstract: BACKGROUND
  In Australia, there is limited evidence on the impact of antenatal depression on perinatal outcomes. This study investigates the association between maternal depressive symptoms during pregnancy and key perinatal outcomes, including birth weight, gestational age at birth, breastfeeding indicators and postnatal depressive symptoms.
  
  
  METHODS
  A retrospective cohort of mothers (N = 17,564) of all infants born in public health facilities within South Western Sydney Local Health District and Sydney Local Health District in 2014, in the state of New South Wales (NSW), Australia, was enumerated from routinely collected antenatal data to investigate the risk of adverse perinatal outcomes associated with maternal depressive symptoms during pregnancy. Antenatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression models that adjusted for confounders were conducted to determine associations between antenatal depressive symptoms and low birth weight, early gestational age at birth (<37 weeks), breast feeding indicators and postnatal depressive symptoms.
  
  
  RESULTS
  The prevalence of maternal depressive symptoms during pregnancy was 7.0% in the cohort, and was significantly associated with postnatal depressive symptoms [Adjusted Odd Ratios (AOR) = 6.4, 95% CI: 4.8-8.7, P<0.001]. Antenatal depressive symptoms was associated with a higher odds of low birth weight [AOR = 1.7, 95% CI: 1.2-2.3, P = 0.003] and a gestational age at birth of <37 weeks [AOR = 1.3, 95% CI: 1.1-1.7, P = 0.018] compared to women who reported lower EPDS scores in antenatal period. Antenatal depressive symptoms were not strongly associated with non-exclusive breast feeding in the early postnatal period.
  
  
  CONCLUSIONS
  Maternal depressive symptoms in the antenatal period are strongly associated with postnatal depressive symptoms and adverse perinatal outcomes in Australian infants. Early identification of antenatal and postnatal depressive symptoms, and referral for appropriate management could benefit not only the mother's mental health, but also the infant's health and development.
authors.affiliation: School of Women's and Children's Health, The University of New South Wales, Kensington, Sydney, NSW, Australia.|Menzies Centre for Health Policy, Charles Perkins Centre, School of Public Health, Sydney University, Sydney NSW, Australia.|School of Public Health, Griffith University, Gold Coast, QLD, Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon NSW Australia.|Ingham Institute for Applied Medical Research, Liverpool NSW Australia.
authors.forename: John
authors.initials: J
authors.lastname: Eastwood
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool NSW Australia.|Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith NSW Australia.
authors.forename: Felix A
authors.initials: FA
authors.lastname: Ogbo
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool NSW Australia.|Coverage and Surveillance, National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hendry
authors.affiliation: Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon NSW Australia.|Ingham Institute for Applied Medical Research, Liverpool NSW Australia.
authors.forename: Justine
authors.initials: J
authors.lastname: Noble
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool NSW Australia.|Coverage and Surveillance, National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Page
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D009035:Mothers / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D018743:Perinatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011295:Prenatal Care / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult