Abstract / Summary
Abstract Antenatal depression is a common mental health disorder associated with adverse maternal, fetal, and neonatal outcomes, yet it frequently remains underrecognized in routine obstetric care. This study aimed to determine the prevalence of antenatal depressive symptoms during the second and third trimesters, identify factors independently associated with depressive symptoms, assess functional impairment, and evaluate whether these associations differed according to gestational trimester. This prospective cross-sectional study was conducted among pregnant women attending the perinatology and obstetrics outpatient clinics of a tertiary referral center. Depressive symptoms were assessed using the validated Turkish version of the Patient Health Questionnaire-9 (PHQ-9), and functional impairment was evaluated using the PHQ-9 functional impairment item. Multivariable logistic regression analysis was performed to identify factors independently associated with antenatal depressive symptoms, followed by interaction analyses to examine whether these associations differed between the second and third trimesters. A total of 852 pregnant women were included. Overall, 22.8% had clinically significant antenatal depressive symptoms. The prevalence was 21.2% in the second trimester and 24.2% in the third trimester, with no significant difference between trimesters (p = 0.295). Functional impairment was substantially more common among women with depressive symptoms than among those without (65.9% vs. 14.6%, p < 0.001). Lower educational attainment, smoking, fetal growth restriction, and a history of psychiatric illness before pregnancy were independently associated with antenatal depressive symptoms. No significant interactions were observed between gestational trimester and any of the identified factors. Antenatal depressive symptoms were common during both the second and third trimesters and were associated with substantial functional impairment. Despite their high prevalence and well-established adverse maternal, fetal, and neonatal consequences, antenatal depression remains relatively underrecognized compared with postpartum depression. Our findings support routine depression screening during pregnancy, with particular attention to women with a history of psychiatric illness, smoking, lower educational attainment, and fetal growth restriction, to enable earlier diagnosis and timely intervention rather than deferring care until the postpartum period. Such an approach may help reduce the burden of antenatal depression and improve maternal, fetal, and neonatal outcomes.