Modelling of psychosocial and lifestyle predictors of peripartum depressive symptoms associated with distinct risk trajectories: a prospective cohort study

Abstract

Perinatal depression involves interplay between individual chronic and acute disease burdens, biological and psychosocial environmental and behavioural factors. Here we explored the predictive potential of specific psycho-socio-demographic characteristics for antenatal and postpartum depression symptoms and contribution to severity scores on the Edinburgh Postnatal Depression Scale (EPDS) screening tool. We determined depression risk trajectories in 480 women that prospectively completed the EPDS during pregnancy (TP1) and postpartum (TP2). Multinomial logistic and penalised linear regression investigated covariates associated with increased antenatal and postpartum EPDS scores contributing to the average or the difference of paired scores across time points. History of anxiety was identified as the strongest contribution to antenatal EPDS scores followed by the social status, whereas a history of depression, postpartum depression (PPD) and family history of PPD exhibited the strongest association with postpartum EPDS. These covariates were the strongest differentiating factors that increased the spread between antenatal and postpartum EPDS scores. Available covariates appeared better suited to predict EPDS scores antenatally than postpartum. As women move from the antenatal to the postpartum period, socio-demographic and lifestyle risk factors appear to play a smaller role in risk, and a personal and family history of depression and PPD become increasingly important.

The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period

“…From this perspective, we, also, documented that lower education level, being unemployed, perceived stress in the last month and the presence of any recent life adversity raised the probability of suffering from depression during pregnancy as compared to postpartum. We, therefore, confirmed previous data reporting that stressful life events are strongly associated with antenatal depression [50,51]. With foreign mothers, in particular, we observed an increasing risk of depression when moving from pregnancy to the postpartum period, perhaps due to cultural and affective separation from a familiar support system that might be necessary especially after childbirth [52].…”

The Anxious Aspects of Insecure Attachment Styles are Associated with Depression Either in Pregnancy or in the Postpartum Period

“…From this perspective, we, also, documented that lower education level, being unemployed, perceived stress in the last month and the presence of any recent life adversity raised the probability of suffering from depression during pregnancy as compared to postpartum. We, therefore, con rmed previous data reporting that stressful life events are strongly associated with antenatal depression [37]. With foreign mothers, in particular, we observed an increasing risk of depression when moving from pregnancy to the postpartum period, perhaps due to cultural and affective separation from a familiar support system that might be necessary especially after childbirth [38].…”

Correlations Between SIRT Genetic Polymorphisms and Postpartum Depressive Symptoms in Chinese Parturients Who Had Undergone Cesarean Section

“… 40 , 41 Our data indicated a role for pregnancy stress, domestic violence, and depressive prenatal mood in PDSs. Consistent with a systematic review, 42 multivariate analysis showed that depressive prenatal mood was a strong predictor of PDSs, and the risk of PDSs in women with depressive prenatal mood during cesarean section was five times that of women with no prenatal depression. It also suggested that in addition to genetic factors that cannot be interfered with, we need to pay attention not only to the postpartum psychological and emotional state but also to understanding the prenatal psychological and emotional state.…”