Depression and/or Anxiety Disorders during the First Trimester Not Preconception Increases the Risk of Low Birth Weight in Offspring: A Prospective Cohort Study

Research question: Are maternal depression and/or anxiety disorders (MDAD) before and during pregnancy associated with IVF outcomes? Design: A total of 5661 women starting their first IVF cycle between 15 August 2014 and 31 December 2015 were pooled from a prospective cohort of IVF-conceived children. The self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used to determine MDAD. IVF outcomes were compared between MDAD+ and MDAD- groups. Results: A total of 10.3% (572/5556) of women had MDAD before IVF (bMDAD). The fertilization rate was lower in the bMDAD+ group (59.41 +/- 22.11% versus 61.72 +/- 22.18%, P-adjust < 0.05). No difference was found in the other IVF outcomes. Pregnancy and neonatal outcomes in women with singleton live births were similar between the two groups. A total of 174% (347) women with singleton live births had MDAD during the first trimester (pMDAD). Birthweight (3383 +/- 556 g versus 3447 +/- 518 g, P-adjust < 0.05) was lower and incidence of low birthweight (LBW) (6.9% versus 3.3%, P-adjust < 0.01) was higher in the pMDAD group. After adjustment for potential confounders (gestational age, maternal age, maternal pre-pregnancy body mass index, threatened abortion, hypertensive disorder complicating pregnancy and gestational diabetes mellitus), pMDAD remained significantly associated with LBW (odds ratio [OR] 2.50, 95% confidence interval [CI]1.16-5.42, P-adjust < 0.05). The preconception psychological state in the pMDAD group did not demonstrate any additional impact on neonatal outcomes. Conclusions: MDAD during the first trimester is associated with increased risk of LBW in offspring, whether preconception MDAD exists or not.