Background: The American College of Obstetricians and Gynecologists issued its first recommendation for universal prenatal depression screening (PDS) in 2015 and reinforced this in 2018. In 2019 the National Committee for Quality Assurance added Prenatal Depression Screening and Follow-up as a quality measure. Language can be a barrier to receipt of recommended screenings. We evaluated how language preference modified uptake of PDS following updated recommendations.

Methods: This retrospective cohort comprised deliveries at or beyond 20 weeks gestation, 2019 to 2024, that initiated prenatal care (PNC) in the first or second trimester. We used logistic generalized estimating equations to account for patients contributing multiple deliveries and calculated marginal probabilities for PDS. An interaction term between language and year assessed if the relationship between preferred language and PDS differed by year of delivery, controlling for maternal age, race/ethnicity, insurance, parity, gestational age, singleton versus multiple gestation, and state of PNC.

Results: Of 91,330 deliveries, patients reported 74 preferred languages: English (94%), Spanish (3%), and Another Language (3%). In 2019, probabilities of PDS were similar across groups: English, 0.50 (95% CI, 0.49–0.51); Spanish, 0.48 (95% CI, 0.40–0.55); and Another Language, 0.50 (95% CI, 0.42–0.58). By 2024, the probability of screening increased to 0.82 (95% CI, 0.82–0.83) for those with English-language preference, 0.69 (95% CI, 0.65–0.74) for Spanish-language preference, and 0.69 (95% CI, 0.64–0.72) for another language preference.

Conclusion: PDS increased from 2019 to 2024, but improvements were not uniform across language groups, resulting in larger screening gaps by 2024 for patients with non‑English language preference. Potential contributors include availability of validated instruments in preferred language, interpreter integration at screening, and clinical workflows.