Lifetime prevalence and correlates of perinatal depression in a case-cohort study of depression

Abstract

ObjectivesThis study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression.Design and settingThe Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms.ParticipantsIn a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively).Primary and secondary outcome measuresThe primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures.ResultsThe prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, p<0.001), non-European ancestry (OR 1.5, 95% CI 1.0 to 2.1, p=0.03), severe nausea during pregnancy (OR 1.3, 95% CI 1.1 to 1.6, p=0.006) and emotional abuse (OR 1.4, 95% CI 1.1 to 1.7, p=0.005).ConclusionsThe majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.

Maternal Metabolites Indicative of Mental Health Status during Pregnancy

“…Alanine, methionine, pyruvate, and glucose remained significant upon fully controlling for the effects of all six covariates prior to FDR adjustment. This finding indicates that these biomarkers may provide additional discriminatory information, and thus a closer relationship with prenatal depression and greater EPDS scores [ 64 , 65 ], not seen for the other metabolites which would benefit from further investigation.…”

Childhood abuse and perinatal outcomes for mother and child: A systematic review of the literature

“…Bahadur et al [86] noted that CEA increased the risk of PPD nearly seven-fold after adjusting for sociodemographic factors, whereas CPA and CSA were not significant. However, a larger Australian study [87] showed a similar but lower risk for CEA (aOR = 1.4). Nagl et al [88] found that women with severe CEA were nearly 20 times more likely to have PPD.…”

Perinatal Depression and Risk of Suicidal Behavior

“…We reported that the risk elevation of suicidal behavior, although attenuated over time, remained elevated even 18 years later. Emerging data indicate that some PND could last for 7 years after delivery and may entail nonperinatal mental disorders . Such consequences may explain the risk of suicidal behavior later in life.…”

“…Emerging data indicate that some PND could last for 7 years after delivery 52 and may entail nonperinatal mental disorders. 53 Such consequences may explain the risk of suicidal behavior later in life. Some risk factors (eg, low social support 54 ) may extend beyond the perinatal period and be associated with increased suicidal behavior in the long run.…”