Different patterns of depressive symptoms during pregnancy

Abstract

Recently, the US Preventive Services Task Force has advocated to screen pregnant and postpartum women for depression. However, we questioned the meaning of a single elevated depression score: does it represent just one episode of depression or do these symptoms persist throughout the entire pregnancy? This study assessed depressive symptoms at each trimester in a cohort of 1813 pregnant women and evaluated whether women with different patterns of depressive symptoms showed other characteristics. Depending on the trimester, elevated depression scores were prevalent in 10–15% of the pregnant women. Up to 4% reported persistent symptoms of depression throughout pregnancy. Different patterns of depressive symptoms were observed, for which persistent symptoms were related to other characteristics than incidentally elevated symptoms. Besides a previous history of mental health problems as best overall predictor, incidentally elevated depression scores were related to major life events. Furthermore, persistently depressive symptoms were related to unplanned pregnancy and multiparity. An EDS assessment at 12 weeks of gestation including three additional items (history of mental health problems, unplanned pregnancy and multiparity) enabled us to identify 83% of the women with persistent depressive symptoms. A depression screening strategy in pregnant women should take into account the potential chronicity of depressive symptoms by repeated assessments in order to offer an intervention to the most vulnerable women.

Anxiety, depression and social support across pregnancy in women with a history of recurrent miscarriage: A prospective study

“…The level of anxiety decreased from early to late pregnancy, while the prevalence of depression declined from early pregnancy to mid-pregnancy and then remained into late pregnancy. These results differed from those reported in low-risk pregnant women with the highest prevalence of anxiety and depression in the third trimester (Dennis et al, 2017;Truijens et al, 2017). The discrepancy might be due to fears about the possibility of miscarriage decreasing and a sense of security about the pregnancy increasing with pregnancy progression.…”

“…The prevalence of depression and anxiety found in the present study was much higher than those found in low-risk pregnant women (Dennis et al, 2017;Gavin et al, 2005;Truijens et al, 2017). The findings of the present study are consistent with previous studies T A B L E 1 Demographic and obstetric characteristic of the participants (n = 166) (Blackmore et al, 2011;Kolte et al, 2019), confirming that women with a history of RM were at higher risk for developing anxiety and depression in subsequent pregnancy, a history of miscarriages and the uncertainty of the present pregnancy could result in elevated anxiety and depression.…”

Anxiety, depression and social support across pregnancy in women with a history of recurrent miscarriage: A prospective study

“…The level of anxiety decreased from early to late pregnancy, while the prevalence of depression declined from early pregnancy to mid-pregnancy and then remained into late pregnancy. These results differed from those reported in low-risk pregnant women with the highest prevalence of anxiety and depression in the third trimester (Dennis et al, 2017;Truijens et al, 2017). The discrepancy might be due to fears about the possibility of miscarriage decreasing and a sense of security about the pregnancy increasing with pregnancy progression.…”

“…The prevalence of depression and anxiety found in the present study was much higher than those found in low-risk pregnant women (Dennis et al, 2017;Gavin et al, 2005;Truijens et al, 2017). The findings of the present study are consistent with previous studies T A B L E 1 Demographic and obstetric characteristic of the participants (n = 166) (Blackmore et al, 2011;Kolte et al, 2019), confirming that women with a history of RM were at higher risk for developing anxiety and depression in subsequent pregnancy, a history of miscarriages and the uncertainty of the present pregnancy could result in elevated anxiety and depression.…”

Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis

“…This might associate with the number of included studies during different trimesters, the pooled prevalence was high where large number of studies included and low where small studies were included as adjustment was not made on the number of studies. Consistent with our findings, one study reported an increased pattern of depression from the first to the second trimester due to increases in a range of risk factors during the three trimesters of pregnancy [113]. Further study could assist in prevention planning in identifying the appropriate timing and frequency of screening and intervention.…”

Longitudinal Changes of Depressive Symptoms in Sedentary Women Who Exercised During Pregnancy

“…For example, Truijens et al found different patterns of depressive symptoms during pregnancy, with the lowest scores occurring during the first trimester and highest rates in the second trimester, followed by a slight decrease in symptoms in the third trimester. 13 Our study findings aligned with these findings. Our study first assessed for depression in the second trimester, which had the highest scores, followed by a decrease in scores in the third trimester, which continued into the postpartum period.…”

Anxiety, depression and social support across pregnancy in women with a history of recurrent miscarriage: A prospective study

“…The level of anxiety decreased from early to late pregnancy, while the prevalence of depression declined from early pregnancy to mid-pregnancy and then remained into late pregnancy. These results differed from those reported in low-risk pregnant women with the highest prevalence of anxiety and depression in the third trimester (Dennis et al, 2017;Truijens et al, 2017). The discrepancy might be due to fears about the possibility of miscarriage decreasing and a sense of security about the pregnancy increasing with pregnancy progression.…”

“…The prevalence of depression and anxiety found in the present study was much higher than those found in low-risk pregnant women (Dennis et al, 2017;Gavin et al, 2005;Truijens et al, 2017). The findings of the present study are consistent with previous studies T A B L E 1 Demographic and obstetric characteristic of the participants (n = 166) (Blackmore et al, 2011;Kolte et al, 2019), confirming that women with a history of RM were at higher risk for developing anxiety and depression in subsequent pregnancy, a history of miscarriages and the uncertainty of the present pregnancy could result in elevated anxiety and depression.…”

Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis

“…This might associate with the number of included studies during different trimesters, the pooled prevalence was high where large number of studies included and low where small studies were included as adjustment was not made on the number of studies. Consistent with our findings, one study reported an increased pattern of depression from the first to the second trimester due to increases in a range of risk factors during the three trimesters of pregnancy [113]. Further study could assist in prevention planning in identifying the appropriate timing and frequency of screening and intervention.…”

Longitudinal Changes of Depressive Symptoms in Sedentary Women Who Exercised During Pregnancy

“…For example, Truijens et al found different patterns of depressive symptoms during pregnancy, with the lowest scores occurring during the first trimester and highest rates in the second trimester, followed by a slight decrease in symptoms in the third trimester. 13 Our study findings aligned with these findings. Our study first assessed for depression in the second trimester, which had the highest scores, followed by a decrease in scores in the third trimester, which continued into the postpartum period.…”

Anxiety, depression and social support across pregnancy in women with a history of recurrent miscarriage: A prospective study

“…The level of anxiety decreased from early to late pregnancy, while the prevalence of depression declined from early pregnancy to mid-pregnancy and then remained into late pregnancy. These results differed from those reported in low-risk pregnant women with the highest prevalence of anxiety and depression in the third trimester (Dennis et al, 2017;Truijens et al, 2017). The discrepancy might be due to fears about the possibility of miscarriage decreasing and a sense of security about the pregnancy increasing with pregnancy progression.…”

“…The prevalence of depression and anxiety found in the present study was much higher than those found in low-risk pregnant women (Dennis et al, 2017;Gavin et al, 2005;Truijens et al, 2017). The findings of the present study are consistent with previous studies T A B L E 1 Demographic and obstetric characteristic of the participants (n = 166) (Blackmore et al, 2011;Kolte et al, 2019), confirming that women with a history of RM were at higher risk for developing anxiety and depression in subsequent pregnancy, a history of miscarriages and the uncertainty of the present pregnancy could result in elevated anxiety and depression.…”

Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis

“…This might associate with the number of included studies during different trimesters, the pooled prevalence was high where large number of studies included and low where small studies were included as adjustment was not made on the number of studies. Consistent with our findings, one study reported an increased pattern of depression from the first to the second trimester due to increases in a range of risk factors during the three trimesters of pregnancy [113]. Further study could assist in prevention planning in identifying the appropriate timing and frequency of screening and intervention.…”

Longitudinal Changes of Depressive Symptoms in Sedentary Women Who Exercised During Pregnancy

“…For example, Truijens et al found different patterns of depressive symptoms during pregnancy, with the lowest scores occurring during the first trimester and highest rates in the second trimester, followed by a slight decrease in symptoms in the third trimester. 13 Our study findings aligned with these findings. Our study first assessed for depression in the second trimester, which had the highest scores, followed by a decrease in scores in the third trimester, which continued into the postpartum period.…”