Maternal Depression in the Prenatal Period: Associated Factors and Intended Infant Sleep Practices

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Context Depression screening during pregnancy is recommended, and is highly predictive of postpartum depression, which can impact adherence to infant care guidance. Objective To identify the prevalence of depression during pregnancy as defined by Edinburgh Postnatal Depression Scale (EPDS) score of 10 or greater and its association with sociobehavioral factors and intended infant care practices. Study Design and Analysis Randomized controlled trial. Frequency of EPDS score 10 or greater was calculated; multiple logistic regression measured the association between elevated EPDS scores and social and behavioral factors, and intended infant feeding and sleep practices. Setting/Population Studied As part of a RCT to promote safe sleep, English- and Spanish-speaking pregnant persons were surveyed who had been recruited through federally funded child feeding programs (WIC) and health centers in 17 states from March 2022-Dec 2024. Surveys were sent at 32-34-weeks’ gestation to collect baseline data. Intervention/Instrument Survey developed for the study. Outcome Measures EPDS scores, social factors, family characteristics, tobacco use, marijuana use, and intended infant feeding and sleep practices. Results 279 of 1468 surveyed persons (19.0%) scored ≥10 on the EPDS. Respondents with education Conclusions A high proportion of pregnant persons screened positive for depression, which was associated with a college education or higher, smoking, marijuana use and higher intent to bedshare. Treating depression in pregnancy may help prevent postpartum depression and its potential impact on infant care practices. It is important to screen for depression in pregnancy to provide early intervention and support.

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