Abstract: Objective To explore the relationship between prenatal depression and delivery types,puerperal complications and fetal outcomes in primiparas. Methods The primiparas admitted to our hospital for delivery from March 1,2019 to September 30,2019 were selected as the research subjects,and they were investigated by the Edinburgh Depression Scale on admission and divided into depression group (191 cases) and non-depression group (572 cases).Binary logistic regression was used to analyze the correlation of prenatal depression with delivery methods,puerperal complications,and fetal outcomes. Results There were 191 cases in the depression group and 572 cases in the non-depression group.The two groups had significant differences in rate of cesarean section (25 cases13.1%vs 44 cases7.7%,P=0.024),placental abruption (3 cases1.6%vs 0 case0,P=0.016),postpartum hemorrhage (19 cases9.9%vs 27 cases4.72%,P=0.009),neonatal transfer to pediatrics (9 cases4.7%vs 8 cases1.4%,P=0.016),premature delivery (8 cases4.2%vs 7 cases1.2%,P=0.024),fetal distress (28 cases14.7%vs 53 cases9.3%,P=0.036),etc;There was no significant difference in forceps delivery,postpartum infections,neonatal weight,length,bust,1-minute Apgar score of newborn,5-minute Apgar score of newborn (all P>0.05).The results of binary logistic regression analysis showed that the delivery types,puerperal complication and adverse fetal outcomes were closely related to prenatal depression in the primiparas (all P<0.05,OR>1). Conclusion Prenatal depression in primiparous women increases the risk of unnatural delivery,puerperal complications and adverse fetal outcomes.Psychological screening and intervention should be carried out to pregnant women as early as possible to ensure the maternal and neonatal safety.