Is Population‐Based Identification of Perinatal Depression and Anxiety Desirable?

Gavin, Norma I.; Meltzer‐Brody, Samantha; Glover, Vivette

doi:10.1002/9781118509722.ch1

Cited by 27 publications

(19 citation statements)

References 139 publications

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“…[8,9] One in five women experience depression in the perinatal period [10], although 60% of women are not detected and clinically diagnosed. [11] A previous episode of perinatal depression is associated with future risk [12], and around 15% of women who experience an episode of depression during pregnancy, experience a new episode within three months postpartum. [11]…”

Section: Introductionmentioning

confidence: 99%

How does perinatal maternal mental health explain early social inequalities in child behavioural and emotional problems? Findings from the Wirral Child Health and Development Study

et al. 2019

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Background This study aimed to assess how maternal mental health mediates the association between childhood socio-economic conditions at birth and subsequent child behavioural and emotional problem scores. Methods Analysis of the Wirral Child Health and Development Study (WCHADS), a prospective epidemiological longitudinal study of the early origins of child mental health (n = 664). Household income at 20-weeks gestation, a measure of socio-economic conditions (SECs) in pregnancy, was the main exposure. The outcome measure was externalising and internalising problems, as measured by the Child Behaviour Checklist at 5 years. We assessed the association of household income with child behavioural outcomes in sequential linear models adjusting for maternal mental health in the pre- and post- natal period. Results Children of mothers in more disadvantaged households had higher scores for externalising behaviour with a difference of 3.6 points comparing the most affluent to the most disadvantaged families (the socio-economic (SEC) gap). In our regression model adjusting for baseline confounders, comparing children of mothers in the most disadvantaged households to the least disadvantaged, we found that most disadvantaged children scored 45 percentage points (95% CI 9, 93) higher for externalising problems, and 42% of this difference was explained in the fully adjusted model. Adjusting for prenatal maternal depressive symptomology attenuated the SEC gap in externalising problems by about a third, rendering the association non-significant, whilst adjusting for pre- and post-natal maternal mental health attenuated the SEC gap by 42%. There was no significant relationship between household income and internalising problems. Conclusion Social disadvantage is associated with higher child externalising behaviour problems score at age 5, and about 40% of this was explained by maternal perinatal mental health. Policies supporting maternal mental health in pregnancy are important to address the early emergence of inequalities in child mental health.

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Section: Introductionmentioning

confidence: 99%

How does perinatal maternal mental health explain early social inequalities in child behavioural and emotional problems? Findings from the Wirral Child Health and Development Study

et al. 2019

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“…In the USA, women with post-partum depression have been found to incur 90% higher health services expenditure than non-depressed postnatal women (Dagher et al, 2012). In the UK, it is estimated that the cost to society of perinatal depression, anxiety and psychosis reaches £8.1 billion every year (Bauer et al, 2014), partly as a result of ineffective or absent treatment, resulting in longer and more severe episodes (Gavin et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Experiences of Improving Access to Psychological Therapy Services for Perinatal Mental Health Difficulties: a Qualitative Study of Women's and Therapists’ Views

Millett

Taylor

Howard

et al. 2017

Behav. Cogn. Psychother.

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“…Despite being treatable, few women experiencing PNA will seek help or be receive efficacious treatment (12)(13)(14). This is concerning, as research suggests untreated PNA may be associated with a variety of long-and short-term consequences in both the mother and infant, including preterm delivery, low birth weight, PND, excessive infant crying, bonding issues, problematic feeding behaviours, and adverse developmental, behavioural and emotional problems in children (9,(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

Harrison

Moore

2020

Preprint

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Background: The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research is area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified, and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Methods: Women who were either pregnant or within one year post-partum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed. Results: Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions: This work provides unique insight into potential sources of anxiety for women in the PNA, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.

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Is Population‐Based Identification of Perinatal Depression and Anxiety Desirable?

Cited by 27 publications

References 139 publications

How does perinatal maternal mental health explain early social inequalities in child behavioural and emotional problems? Findings from the Wirral Child Health and Development Study

How does perinatal maternal mental health explain early social inequalities in child behavioural and emotional problems? Findings from the Wirral Child Health and Development Study

Experiences of Improving Access to Psychological Therapy Services for Perinatal Mental Health Difficulties: a Qualitative Study of Women's and Therapists’ Views

Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

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