Prenatal depression is a substantial contributor to maternal morbidity, and screening is an entry point to psychiatric assessment and treatment during pregnancy. Following updated guidelines and quality metrics for prenatal depression screening, we evaluated whether screening uptake differed by preferred language within a large U.S. healthcare system. We used electronic health record data to identify a retrospective cohort of deliveries at or beyond 20 weeks gestation in 2019-2024. We used logistic regression with a language-year interaction to estimate the adjusted marginal probabilities of screening by language preference. Among 99,526 pregnancies (82,632 individuals), screening increased substantially over time but increases differed across language groups (p<0.001). In 2019, screening probabilities were similar (English 0.50; Spanish 0.48; Another Language 0.50). By 2024, probabilities diverged (English 0.81; Spanish 0.66; Another Language 0.71). Unequal screening uptake can systematically under-identify prenatal depression among patients with non-English language preference, with implications for equitable access to psychiatric care.

The authors have declared no competing interest.

This research was supported by a Live Well Intramural Pilot Grant from the Advocate Aurora Research Institute.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The IRB of Wake Forest University School of Medicine gave ethical approval for this work.

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Declaration of Interest: None

Funding Statement: This research was supported by a Live Well Intramural Pilot Grant from the Advocate Aurora Research Institute.

The data that support the findings of this study are available on request from the corresponding author, subject to institutional data sharing procedures. The data are not publicly available to protect patient privacy.