Prevalence of Perinatal Psychiatric Morbidities and its Association with Maternal and Neonatal Outcomes in a Tertiary Care Setting in India: A Prospective Cohort Study

Background: Perinatal psychiatric morbidity is common but frequently under-recognized and may adversely affect maternal and neonatal outcomes. This study assessed their prevalence and association with maternal coping, obstetric complications, and neonatal outcomes. Methods: This prospective observational cohort study was conducted at a tertiary care hospital in Gujarat between 2022 and 2024. A total of 300 pregnant women were followed prospectively, with psychiatric assessment at available trimester-specific visits and six weeks postpartum. using the DSM-5 Level 1 Cross-Cutting Symptom Measure. Women screening positive underwent further assessment using validated psychiatric scales. Maternal and neonatal outcomes were recorded and analyzed using chi-square test and logistic regression. Results: Psychiatric morbidity was identified in 54 (18%, 95% CI 14.1%-22.7%) women, with depression, sleep disturbances, and anxiety being the most common conditions. In conventional multivariable logistic regression, psychiatric morbidity was associated with antepartum anaemia (AOR=3.98, p=0.002), antenatal complications (AOR=2.54, p=0.005), low birth weight (AOR=3.89, p<0.001), NICU admission (AOR=3.67, p<0.001), and neonatal complications (AOR=3.41, p=0.002). Firth penalized sensitivity analyses attenuated the associations with NICU admission and neonatal complications. Conclusion: Perinatal psychiatric morbidity is common and associated with adverse maternal and neonatal outcomes. Routine mental health screening during antenatal care may improve maternal and neonatal health.