What Role Does Hispanic/Latina Ethnicity Play in the Relationship Between Maternal Mental Health and Preterm Birth?

Objective To investigate the association of prepregnancy and prenatal depression and/or anxiety on preterm birth (PTB), while also exploring Hispanic/Latina ethnicity as a potential effect modifier. Methods Study population included respondents of UT-PRAMS (2016-2019). Associations between prepregnancy and prenatal depression and/or anxiety and PTB were evaluated using Poisson regression models accounting for stratified survey sampling. Results Women with prepregnancy and prenatal depression and anxiety, compared to those without, had a 67 percent (95% CI: 19%, 134%) higher probability of experiencing PTB, after controlling for relevant sociodemographic, lifestyle, and reproductive history factors. Impact of depression on PTB was slightly higher than impact of anxiety. Hispanic/Latina ethnicity was found to protect against PTB for those with prepregnancy and prenatal depression alone (aPR: 0.53, 95% CI: 0.24, 1.21) or both depression and anxiety (aPR: 0.51, 95% CI: 0.18, 1.40) compared to being non-Hispanic/Latina (aPR: 1.79, 95% CI: 1.25, 2.55 for depression alone; aPR: 1.62, 95% CI: 1.18, 2.21 for depression and anxiety). Conclusions Overall, Utah women reporting prepregnancy and prenatal depression and anxiety were more likely to have a PTB. Being of Hispanic/Latina ethnicity was found to mitigate the risk of PTB among women with depression and anxiety. Implications Prepregnancy and prenatal mental health screenings and treatment are key to lessening the impacts of depression and anxiety on both mother and infant. Hispanic/Latina ethnicity may be protective against PTB among women experiencing mental distress. Whether this is through increased social support or through a different mechanism should be explored in future research.