Prenatal parental depression and preterm birth: a national cohort study

Objective To investigate the effects of maternal and paternal depression on the risk for preterm birth. Design National cohort study. Setting Medical Birth Register of Sweden, 2007-2012. Population A total of 366 499 singleton births with linked information for parents' filled drug prescriptions and hospital care. Methods Prenatal depression was defined as having filled a prescription for an antidepressant drug or having been in outpatient or inpatient hospital care with a diagnosis of depression from 12 months before conception until 24 weeks after conception. An indication of depression after 12 months with no depression was defined as 'new depression', whereas all other cases were defined as ` recurrent depression'. Main outcome measures Odds ratios (ORs) for very preterm (22-31 weeks of gestation) and moderately preterm (32-36 weeks of gestation) births were estimated using multinomial logistic regression models. Results After adjustment for maternal depression and sociodemographic covariates, new paternal prenatal depression was associated with very preterm birth [adjusted OR (aOR) 1.38, 95% confidence interval (95% CI) 1.04-1.83], whereas recurrent paternal depression was not associated with an increased risk of preterm birth. Both new and recurrent maternal prenatal depression were associated with an increased risk of moderately preterm birth (aOR 1.34, 95% CI 1.22-1.46, and aOR 1.42, 95% CI 1.32-1.53, respectively). Conclusions New paternal and maternal prenatal depression are potential risk factors for preterm birth. Mental health problems in both parents should be addressed for the prevention of preterm birth.