Pietro Gambadauro, M.D., Ph.D.,a,b Stavros Iliadis, M.D., Ph.D.,b Emma Bränn, M.Sc.,b and Alkistis Skalkidou, M.D., Ph.D.b
a Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm; and b Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
Fertil Steril 2017 Aug;108(2):325-332. DOI: 10.1016/j.fertnstert.2017.06.006
Objective: To study whether conception by means of in vitro fertilization (IVF) is associated with maternal depressive symptoms during pregnancy or postpartum.
Design: Longitudinal observational study.
Setting: University hospital.
Patient(s): A total of 3,283 women with singleton pregnancies receiving antenatal care and delivering in Uppsala from 2010 to 2015.
Intervention(s): A web-based self-administered structured questionnaire including sociodemographic, clinical and pregnancy-related items, and the Edinburgh Postnatal Depression Scale (EPDS) was delivered at 17 and 32 gestational weeks and at 6 weeks and 6 months postpartum.
Main Outcome Measure(s): Prevalence of significant depressive symptoms (EPDS ≥12) and EPDS scores.
Result(s): A total of 167 women (5%) had conceived via IVF and 3,116 (95%) had a spontaneous pregnancy. IVF mothers were more frequently ≥35 years of age (46.1% vs. 22.6%) and primiparous (71.7% vs. 49.9%) and had a higher cesarean delivery rate (22.4% vs. 14.2%). Demographic and clinical characteristics were otherwise similar between the two groups. Significant depressive symptoms were reported by 12.8%, 12.4%, 13.8%, and 11.9% of women at 17 and 32 gestational weeks and 6 weeks and 6 months postpartum, respectively. The prevalence of depressive symptoms and the EPDS scores during pregnancy and postpartum were similar between women conceiving spontaneously or through IVF. The mode of conception was not associated with significant depressive symptoms at any time point, even when adjusting for several possible confounders in multivariable logistic regression analysis.
Conclusion(s): Despite the psychologic distress characterizing subfertility and its treatment, conception by means of IVF is not associated with maternal depressive symptoms during pregnancy or postpartum.
Key Words: In vitro fertilization, assisted reproductive technologies, pregnancy complications, depression, postpartum depression