First trimester depression and/or anxiety disorders increase the risk of low birthweight in IVF 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%, Padjust < 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 17.4% (347) women with singleton live births had MDAD during the first trimester (pMDAD). Birthweight (3383 ± 556 g versus 3447 ± 518 g, Padjust < 0.05) was lower and incidence of low birthweight (LBW) (6.9% versus 3.3%, Padjust < 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, Padjust < 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.