Table 1. Association of depression during pregnancy and pregnancy outcomes.

SGA = small for gestational age; ASD = autism spectrum disorder; PTB = preterm birth; LGA = large for gestational age; CS = cesarean section; IUGR = intrauterine growth retardation; SCN = special care nursery; NICU = neonatal intensive care unit; PHQ9 = Patient Health Questionnaire-9; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Edition 4; DADP = depression and anxiety during pregnancy; CES-D = Center for Epidemiological Studies-Depression; EDPS = Edinburgh Postnatal Depression Scale.

Authors and year	Study types	Purpose of study	Study characteristics	Sample size	Depression measures	Actual result	Conclusion
Weobong et al. (2014) [8]	Cohort study	To investigate the effects of depression on a baby's survival	To identify pregnancies and collect data on births and deaths, a cohort study was placed within four-weekly surveillance of all women of reproductive age	n = 20,679	PHQ9 to ascertain and DSM-IV to determine major or minor depression	Premature labor, peripartum difficulties, postpartum complications, non-vaginal delivery, infant sickness, and bed net use during pregnancy were found linked, but neonatal fatalities, stillbirths, low birth weight, immediate breastfeeding initiation, or exclusive breastfeeding did not indicate any link	This leads to premature labor, peripartum difficulties, postpartum complications, non-vaginal delivery, infant sickness, and bed net use during pregnancy
Xu et al. (2020) [1]	Cohort study	To see if prenatal depression throughout late pregnancy has an impact on maternal and infant outcomes	Clinical data of subjects were divided into three groups: mild-to-moderate depression, severe depression, and non-depression	n = 595	Edinburgh Postnatal Depressive Scale (EPDS)	Pregnant patients with severe depression were more likely to have preterm delivery than women without depression or with mild-to-moderate depression	Preterm birth is substantially linked to severe prenatal depression throughout late pregnancy, whereas mild-to-moderate prenatal depression had little effect on mother or neonatal outcomes
Mochache et al. (2018) [3]	Cohort study	The goal of this study was to see if prenatal depression is linked to preterm birth	Even though 292 women were recruited, only 255 were successfully followed up to delivery, owing to a 12.7% attrition rate	n = 292	Edinburgh Postnatal Depression Scale (EPDS)	Those with depressive symptoms had a 3.8 times increased risk of giving birth prematurely	There was a link between prenatal depression and premature labor and delivery
Szegda et al. (2017) [4]	Cohort study	To look at the associations between depression, preterm birth, and small for gestational age	Early, mid, and late pregnancy interviews were conducted	n = 1,262	Edinburgh Postnatal Depression Scale (EPDS)	Mid-pregnancy depression increased the risk for SGA. SGA was not associated with late pregnancy depression; preterm birth was not associated with depression during pregnancy	Mid-pregnancy depression increased the incidence of SGA in this cohort of mostly Puerto Rican women
Fekadu Dadi et al. (2020) [9]	Cohort study	To determine the prevalence of unfavorable birth outcomes, as well as the direct and indirect pathways through which depression and other psychosocial risk factors may influence these outcomes	Women in their second or third trimester were followed for a month after giving birth	n = 916	Edinburgh Postnatal Depression Scale (EPDS)	In general, there was no association between antenatal depression and preterm birth. However, depression was modified by partner support and stress coping ability, and preterm birth was 4.38 and 4.99 times higher for those with poor spouse support and poor stress coping ability	No association is indicated between antenatal depression and preterm birth
Choi et al. (2014) [10]	Cohort study	To see if antenatal depressed symptoms have an impact on obstetric outcomes and if there are any links between antenatal and postpartum depression	Pregnant women in their third trimester of pregnancy who were getting obstetrical care; participants were split into two groups based on EPDS scores: non-depressed (n = 344, EPDS score 9) and depressed (n = 123, EPDS level 10)	n = 467	Edinburgh Postnatal Depression Scale (EPDS)	With EPDS scores of ≥10, 26.34% (n = 123) of the 467 patients exhibited prenatal depressive symptoms. Prenatal depression symptoms were not linked to any significant perinatal consequences. A total of 192 women from the initial study cohort were given the EPDS again as a follow-up during the postpartum period. A total of 56 (29.17%) of the 192 participants received a score of 10 or higher. The prenatal and postpartum EPDS scores had a Spearman correlation coefficient of 0.604, which was statistically significant (P = 0.001)	Antenatal depression is not associated with poor perinatal outcomes. Screening for antenatal depression, on the other hand, may be useful in identifying women at risk of postpartum depression
Hagberg et al. (2018) [11]	Cohort study with nested sibling case-control analysis	To estimate the risk of ASD in children of women who had depression during pregnancy and use antidepressants compared to those who were not	Mother–baby pairings with a 12-month history of depression before delivery and a three-year follow-up period for the kid	n = 194,494	Known case of depression population	According to the findings, women who experience depression during pregnancy have a higher probability of having a kid with ASD than women who are not exposed	Women who are depressed during pregnancy have a higher risk of having a child with ASD, regardless of whether they take antidepressants
Benatar et al. (2020) [5]	Cohort study	To find out how common depression is among pregnant Medicaid recipients and what the link is between depression and pregnancy outcomes	From 2013 to 2017, Medicaid individuals registered in Strong Start for Mothers and Newborns 2, a national preterm birth prevention program, with a single pregnancy and reliable depression data	n = 37,287	Depression screening (a shortened version of the Center for Epidemiological Studies – Depression [CES-D] scale)	Women who screen positive for depression have a 2.5% increased chance of having a preterm birth (12.5% vs. 10.0%), a 2.4 percentage point higher probability of their infant being low birth weight (10.9% vs. 8.4%), and a 2.6 percentage point higher probability of C-section birth (28.8% vs. 26.3%) than women who are not depressed	Depression is positively correlated to preterm birth, low birth weight, and probability of C-section
Flynn et al. (2015) [12]	Cohort study	To find the effect of prenatal depression and anxiety on key infant outcomes (gestational age at birth, birth weight, and Apgar scores), and maternal medical conditions	Women who were presenting consecutively for prenatal care at a health system serving primarily Medicaid patients and information on maternal characteristics, maternal medical health as well as mental health were extracted	n = 419	Patient Health Questionnaire-9 (PHQ-9) and obstetrics clinician documentation of depression or anxiety	This study suggests that the interaction of prenatal depression and anxiety with medical conditions may have a greater impact on birth weight and gestational age	Prenatal depression and anxiety affect birth weight and gestational age
Yang et al. (2017) [13]	A population-based cohort study was used to create a nested case-control study	To find the effect of depression, anxiety, and both on low birth weight (LBW); and to examine if preterm birth (PTB) moderates these associations	The study used the Electronic Perinatal Health Care Information System to extract cases and controls	n (cases) = 5,457; n (control) = 2,853	Custom questionnaire	Depression and anxiety during pregnancy (DADP) are related to a greater incidence of LBW, with PTBs having the strongest association	The presence of DADP was associated with an increased risk of LBW
Nutor et al. (2018) [14]	Retrospective cohort study	The goal of this study was to look at the relationship between depressive symptoms and preterm birth while controlling for social support, both general and from the baby's father	Women were interviewed during their postpartum hospitalization 24 to 48 hours after birth. Medical records were used to obtain information about the neonates and their mothers' health	n = 1,207	Center for Epidemiological Studies-Depression (CES-D); CES-D scores ≥23 considered severe	Around 17% of the women in the sample had a PTB, while 20% of the women in the sample had a CES-D score of ≥23. After adjusting for both general social support and father of the baby support, women with a CES-D score of >23 were nearly 70% more likely to have a PTB than women with a CES-D score of <23 (PR = 1.68, 95% CI: 1.24-2.16)	Women with severe depression were almost twice more likely to have PTB compared with women with not severe depression
Smith et al. (2015) [15]	Retrospective cohort study	To investigate whether maternal depression during pregnancy affected adverse birth outcomes, specifically preterm birth and small for gestational age (SGA)	Used the Utah Pregnancy Risk Assessment Monitoring System, which is an ongoing surveillance initiative that analyzes maternal behaviors in women who have recently given birth	n = 4,123	Custom questionnaire	Women who were told they had depression by a doctor, nurse, or other health care worker during pregnancy had statistically significantly increased odds of preterm birth as compared to women who were not told they had depression. However, after adjustment for prenatal care visits, the depression–preterm birth association was attenuated and no longer statistically significant	The findings of this study do not find the correlation between maternal depression and adverse birth outcomes
Li et al. (2020) [16]	Prospective cohort study	To examine the associations of antenatal depression symptoms with pregnancy outcomes, especially for low birth weight	Unfavorable outcomes in pregnant women with prenatal depression were calculated using multivariate logistic regression (CI) that represented as odds ratio (OR) and 95% confidence interval (CI)	n = 1,377	The Edinburgh Postnatal Depression Scale (EPDS) questionnaire was used to assess depressive symptoms in the second trimester of pregnancy; EPDS ≧ 12 scores were included	After adjusting for maternal age, education, parity, pre-pregnancy BMI, residential region, and fetal gender, an EPDS score of ≥12 (vs. <12) was attributed to an elevated risk of low birth weight but not preterm birth, large for gestational age, small for gestational age, or macrosomia	Low birth weight is linked to maternal depression, although there is no link to preterm birth, SGA, LGA, or macrosomia
Rawahi et al. (2020) [17]	Prospective cohort study	To determine if there is a relationship between antenatal depression and pregnancy outcomes, including the risk of postpartum depression	Women with a gestational age of ≥32 weeks who were receiving antenatal care at 12 local health centers in Muscat, Oman, were invited to participate	n = 959	The Edinburgh Postnatal Depression Scale (EPDS)	Antenatal depression was associated with a greater risk of CS and postnatal depression, according to a logistic multivariate regression study	An increased risk of CS and postnatal depression is linked to antenatal depression
Eastwood et al. (2017) [18]	Retrospective cohort study	To look at the association between maternal depressive symptoms and key perinatal outcomes including birth weight, gestational age at birth, breastfeeding indicators, and postnatal depressive symptoms during pregnancy	Women were identified from routinely recorded antenatal data and determined the risk of adverse perinatal outcomes associated with maternal depression during pregnancy. Logistic regression models that adjusted for confounders were used to determine the result	n = 17,564	Edinburgh Postnatal Depression Scale (EPDS)	The cohort had a 7.0% prevalence of maternal depressive symptoms during pregnancy, which was strongly associated with postnatal depressive symptoms. Depressive symptoms before conception were associated with a higher odds of low birth weight and preterm birth compared to women who reported lower EPDS scores in the antenatal period. In the early postnatal period, antenatal depression symptoms were not strongly linked to non-exclusive breastfeeding	Prenatal maternal depressive symptoms are closely linked to postnatal depressive symptoms and negative perinatal outcomes
Sabri et al. (2015) [19]	Prospective cohort study	To assess the risk of preterm delivery and IUGR related to antenatal anxiety and depression throughout early pregnancy, as well as to assess their impact on fetal growth and birth outcome	In the late second trimester, the mother's sociodemographic data, EPDS, and the Beck Anxiety Inventory (BAI) were examined; fetal growth and activity were assessed during the ultrasound examination, as well as the doppler waveforms investigation of the umbilical vessels after 30 weeks of pregnancy	n = 54	Edinburgh Postnatal Depressive Scale (EPDS) and the Beck Anxiety Inventory (BAI)	Women experiencing depressive and anxiety symptoms in the third trimester of pregnancy are more likely to have oligohydramnios, IUGR, decreased placental perfusion, and preterm labor, according to this study	Various fetal developmental abnormalities have been related to maternal depression and anxiety symptoms during pregnancy
Uguz et al. (2019) [20]	Cross-sectional study design	To see how maternal major depression, anxiety disorders, and their comorbidities affect infants' gestational age and birth weight	The study comprised 1119 women, including 26 women having only major depression, 125 women having an only anxiety disorder, 36 women having severe depression plus anxiety disorder, and 932 women having no mental problems	n = 1,119	Structured psychiatric interviews were conducted using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (SCID-I)	The comorbid group had the highest percentage of babies who were born prematurely or with low birth weight	During pregnancy, comorbidity between serious depression and anxiety disorders may have significant unfavorable consequences on birth weight and gestational age
Khanghah et al., 2020 [21]	Cohort study	The goal of this study was to see if there was an association between antenatal depression, pregnancy, and neonatal outcomes	This study used a convenient sample approach and collected data using questionnaires on demographic and obstetric variables, the CES-D depression scale, and a pregnancy outcome checklist	n = 394	Center for Epidemiological Studies-Depression (CES-D)	Preeclampsia, premature membrane rupture, preterm delivery, cesarean section, intrauterine fetal death, and intrauterine fetal growth restriction were higher among mothers with depression during their pregnancies. The mean birth weights of depressed mothers' infants were lower than the infants of mothers who did not have depression	Depression is associated with a worse pregnancy and neonatal outcome when it occurs during pregnancy
Dowse et al. (2020) [22]	Retrospective cohort study	To see if there is any connection between self-reported depression, self-reported anxiety, and neonatal birth outcomes using EPDS scores	Linear regression and logistic regression were used to examine the effect on birth weight, gestational age, admission to the NICU or the SCN, birth outcome (stillborn vs. live birth), and Apgar scores. The influence on the newborn length of stay was estimated using Cox proportional hazards regression	n = 53,646	The Edinburgh Postnatal Depression Scale	Women with self-reported anxiety were more likely to have birth complications, have more hospital admission, have worse Apgar ratings, and spend longer in the hospital. Babies born to women who self-identify as depressed are more likely to have a lower birth weight, shorter gestational age, and a worse Apgar score with a longer stay in the hospital	Lower birth weight, shorter gestational age, and lower Apgar score are all associated with maternal depression
Hermon et al. (2019) [23]	Cohort study	To estimate the risk of maternal depression among women hospitalized in a high-risk pregnancy department, and to evaluate its potential association with adverse perinatal outcome	During the study period, 279 women met the inclusion criteria. Among them, 28.3% (n = 79) screened positive for depression (≥10 points on the EPDS)	n = 279	The Edinburgh Postnatal Depression Scale (EPDS)	Preterm birth, low birth weight, low Apgar scores, and neonatal intensive care unit (NICU) admissions were all shown to be significantly higher in the screen-positive group in the univariate analysis. Maternal antenatal depression during hospitalization was found to be an independent risk factor for preterm delivery in a multivariate regression model that controlled for maternal age, ethnicity, gestational diabetes mellitus, preeclampsia, previous preterm delivery, and gestational age at admission	Maternal depression is associated with adverse perinatal outcomes