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Study nurses assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CESD\u201010), social support using the Medical Outcomes Survey scale (MOS\u2010SSS), intimate partner violence (IPV) with the Hurt, Insult, Threaten, Scream scale (HITS), and pregnancy outcomes at 6\u2009weeks postpartum. Cox proportional hazards models were used to evaluate relationships between depressive symptoms (moderate\u2010to\u2010severe [MSD, CESD\u201010 \u226510] and mild\u2010to\u2010severe [Mild\u2010SD, CESD\u201010 \u22655]), low social support (MOS\u2010SSS &lt;72), and IPV (HITS \u226510) with adverse perinatal outcomes of pregnancy loss, stillbirth, preterm birth (PTB), small for gestational age, and neonatal mortality. We also estimated the population attributable risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 4153 women, 23.9% (<jats:italic>n<\/jats:italic>\u2009=\u2009994) had MSD, 54.7% (<jats:italic>n<\/jats:italic>\u2009=\u20092273) mild\u2010SD, 37.3% (<jats:italic>n<\/jats:italic>\u2009=\u20091550) low social support, and 7.8% (<jats:italic>n<\/jats:italic>\u2009=\u2009323) experienced IPV. Pregnancy loss was 5\u2010fold higher among women with MSD (adjusted hazard ratio [HR] 5.04, 95% confidence interval [CI] 2.44, 10.42); 37.4% of losses were attributable to MSD. Mild\u2010SD was associated with PTB (HR 1.39, 95% CI 1.03, 1.87). Stillbirth risk more than doubled among women reporting low social support (HR 2.37, 95% CI 1.14, 4.94).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adverse perinatal outcomes were common and associated with prenatal depressive symptoms and low social support in this large cohort of Kenyan mother\u2013infant pairs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12978","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T11:06:38Z","timestamp":1682507198000},"page":"489-504","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Risks of adverse perinatal outcomes in relation to maternal depressive symptoms: A prospective cohort study in Kenya"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0096-9386","authenticated-orcid":false,"given":"Anna","family":"Larsen","sequence":"first","affiliation":[{"name":"Department of 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