SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. Mood Disorders
Association between maternal depressive symptoms during pregnancy and the risk of preeclampsia: a meta-analysis
Provisionally accepted
- Xiangtan Central Hospital, Xiangtan, China
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Background: Depression during pregnancy is common and has been proposed as a potential risk factor for preeclampsia, but observational studies have reported inconsistent findings. This meta-analysis aimed to evaluate the association between maternal depressive symptoms during pregnancy and the subsequent risk of developing preeclampsia. Methods: PubMed, Embase, and Web of Science were systematically searched for observational studies evaluating depressive symptoms during pregnancy (measured before any assessment for preeclampsia) and reporting clinically diagnosed preeclampsia. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model accounting for the potential influence of heterogeneity. Results: Nine cohort studies involving 44,559 pregnant women, of whom 6,934 (15.6%) had depressive symptoms during pregnancy, were included. Maternal depressive symptoms was associated with a higher risk of preeclampsia (OR: 1.89; 95% CI: 1.17–3.03; p < 0.001; I² = 66%). The association was consistent across study design (prospective vs. retrospective), maternal age (< 29 vs. ≥ 29 years), and preeclampsia definition (hypertension plus proteinuria vs. hypertension plus organ involvement, p for subgroup difference all > 0.05). Stronger associations were observed in studies adjusting for parity (OR: 3.42 vs. 1.35; p for subgroup difference = 0.02). Adjustment for maternal body mass index attenuated the association (OR: 1.43 vs. 2.93; p for subgroup difference = 0.05). Conclusions: Depressive symptoms during early pregnancy is associated with an increased risk of subsequent preeclampsia. These findings highlight the importance of screening and monitoring depressive symptoms in routine prenatal care.
Keywords: depressive symptoms, Meta-analysis, Preeclampsia, Pregnancy, risk factor
Received: 10 Dec 2025; Accepted: 26 Jan 2026.
Copyright: © 2026 Yi, Cheng, Peng, Su, Cao and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fangqun Cheng
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