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.

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.…”

Psychometric aspects of the Tilburg Pregnancy Distress Scale: data from the HAPPY study

“…Considering the PI subscale items, women without a partner (n = 12) were excluded from the analysis. A final sample of 1739 women were suitable for analysis, and of whom the characteristics (demographics, lifestyle habits, obstetrics, and psychiatric history) were not different from the original sample as published elsewhere in the current journal (Truijens et al 2017), in which scores of the Edinburgh (Postnatal) Depression Scale (E(P)DS; Cox et al 1987) were also repeatedly assessed at all trimesters. The study was approved by the Psychology Ethics Committee of Tilburg University (protocol number EC-2012.25).…”

Effectiveness of a guided ACT-based self-help resilience training for depressive symptoms during pregnancy: Study protocol of a randomized controlled trial embedded in a prospective cohort

“…Antepartum depressive symptoms and subclinical depression with prevalence rates ranging from 10 to 20%, often remain unnoticed by maternity care providers during antenatal visits [ 1 ]. However, early detection is crucial because symptoms of depression or anxiety may result in antepartum depression with prevalence rates ranging from 5 to 13% or in postpartum depression (PPD) with prevalence rates of 10 to 15% [ 2 , 3 ].…”