Prenatal depression comorbid with diabetes or hypertension and the risk of adverse neonatal outcomes: A systematic review and meta-analysis

Purpose

This systematic review and meta-analysis aim to synthesise evidence on the association between prenatal depression comorbid with diabetes and/or hypertension and adverse birth outcomes.

Methods

A comprehensive literature search was conducted across PubMed, Medline, Scopus, Web of Science, Embase, PsycINFO, and Google Scholar. Eligible studies assessed the effect of comorbid prenatal depression and diabetes or hypertension on obstetric or neonatal outcomes. Methodological quality was appraised using the Joanna Briggs Institute tool. Random-effects meta-analyses were conducted using inverse-variance weighting. Subgroup, sensitivity, and publication bias analyses were also performed.

Results

Fourteen studies, comprising over 11 million participants, were included. Prenatal depression comorbid with hypertension was significantly associated with increased risks of preterm birth (OR = 2.09; 95 % CI: 1.04–4.19), low birth weight (LBW) (OR = 2.08; 95 % CI: 1.07–4.07), and small for gestational age (SGA)(OR = 1.34; 95 % CI: 1.11–1.60). Additionally, comorbid prenatal depression and diabetes were associated with higher odds of cesarean section (CS) delivery (OR = 1.42; 95 % CI: 1.36–1.47).

Conclusions

The findings suggest that prenatal depression comorbid with gestational diabetes or hypertension may increase the risk of adverse birth outcomes, including preterm birth, LBW, SGA, and CS delivery. These findings underscore the need for early identification and targeted management of such comorbidities. Integrated treatment approaches that combine mental and physical healthcare may be essential to improve outcomes for both mothers and infants.