Maternal Antibiotic Exposure and the Risk of Developing Antenatal or Postpartum Depressive Symptoms: The Maternal Experience Study Protocol

Abstract

Limited epidemiological evidence suggests a link between antibiotic use and developing depression. This study seeks to investigate this association in depth, using a cohort of pregnant individuals. The primary aim is to explore any association between the use of antibiotics during pregnancy and the development of antenatal depressive symptoms up to the third trimester, as well as the use of antibiotics during pregnancy and within 12 months postpartum and the development of postpartum depressive symptoms. A national prospective, observational, longitudinal cohort study has been designed to examine these relationships. A sample size of 1500 pregnant individuals has been sought for this study, assuming 10 potential predictor variables (including antibiotic use) in the final multiple logistic regression model and allowing for a 30% drop-out rate. The development of depressive symptoms is considered either a diagnosis by a medical doctor and/or a scoring 13 or higher on the Edinburgh Postnatal Depression Scale. Data will be collected during the third trimester and at 6 weeks, 6 months, and 12 months postpartum. These surveys include variables previously identified as associated with antenatal and postpartum depression (e.g., level of social support, experience of intimate partner abuse, and obstetric complications), as well as antibiotic and probiotic use. This study will provide an update on the prevalence of the symptoms of depression during pregnancy and postpartum and its associated risk factors. It will also, for the first time, comprehensively explore the potential association between antibiotic use during pregnancy and up to 12 months postpartum and the development of depressive symptoms.

Maternal Antibiotic Exposure and the Risk of Developing Antenatal Depressive Symptoms

“…The data reported in this paper are from an ongoing Australia-wide prospective longitudinal observational cohort study, called “ The Maternal Experience Study: Factors affecting your health and wellbeing following the birth of your child ”, and detailed information on the methodology has been previously reported [ 18 ]. In brief, the study includes four online surveys to be completed over the course of each participant’s pregnancy and postpartum journey.…”

“…Where possible, validated scales or previously used questionnaires were used [ 18 ], including the Edinburgh Postnatal Depression Scale (EPDS) [ 19 ]. The EPDS is a 10-item scale designed to identify participants experiencing depressive symptoms in the postpartum period; however, it has also been validated for use in pregnancy [ 20 ].…”

“…From there, the de-identified quantitative data were analysed using version 27.0 of SPSS (Statistical Package for Social Sciences, IBM ® Armonk, New York, NY, USA). Quantitative data were gathered using previously validated scales and tools (for a full description, see protocol study [ 18 ]). Many of these, including variables gathering information pertaining to symptoms of depression, stress, and anxiety, and those exploring quality of sleep, level of social support, and whether abuse from an intimate partner had been experienced in the prior 12 months, were analysed using pre-defined category boundaries.…”