The impact of parental antepartum depressive and anxiety symptoms on low birth weight newborns

Abstract

Despite significant improvement in health status in Malaysia, the prevalence of low birth weight (LBW) infants still remains static over the past 12 years. LBW newborns are at higher risk for perinatal and infant mortality. Prior evidence from developed and developing countries indicates the association between maternal antepartum depressive and anxiety symptoms with infant low birth weight is inconsistent. There is no study in Malaysia that shows the impact of parental depressive and anxiety symptoms on LBW. This study aims to investigate the independent effect of parental antepartum depressive and anxiety symptoms on infant LBW in Kuantan, Pahang. A prospective cohort study of 450 pregnant women and their spouses was carried out in six conveniently selected government health clinics in Kuantan, Pahang. Antepartum depressive symptoms were assessed using Edinburgh Postpartum Depression Scale (EPDS) and anxiety symptoms using Depression Anxiety Stress Scale-21 (DASS-21) anxiety scale and they were followed-up until delivery. Baseline data provided socioeconomics, anthropometrics, reproductive, obstetric and social support information. Infant birth weight of 445 (98%) singleton live babies born at term (≥37 weeks) were recorded to the nearest 0.1kg from Infant and Child Health Record. Length of pregnancy, mode and place of delivery, complications during labour, live or stillbirth, weight, height, and head circumference of the newborn were also recorded. Chi-square and independent sample t-test were done as descriptive statistics and a multiple logistic regression model was used to identify predictors of LBW. After adjusting for potential confounders, maternal depressive (OR=5.02; 95% CI 1.75-14.43), paternal depressive (OR=4.29; 95% CI 1.17-15.72), and paternal anxiety (OR= 4.62; 95% CI 1.74-12.26) symptoms were significantly associated with LBW (≤2.5kg). Low monthly household income, maternal malnutrition, being firstborn and shorter duration of pregnancy were also associated with LBW. As a conclusion, this study shows that maternal depressive symptoms and paternal depressive and anxiety symptoms during pregnancy predict the LBW of newborns. Therefore, it is crucial to detect and manage the depressive and anxiety symptoms for both the mothers and their spouses, which may help preventing LBW among newborns in Malaysia.