Perinatal depressive symptoms often start in the prenatal rather than postpartum period: results from a longitudinal study

Abstract

Depressive symptoms during and after pregnancy confer risks for adverse outcomes in both the mother and child. Postpartum depression is traditionally diagnosed after birth of the child. Perinatal depression is a serious, prevalent heterogeneous syndrome that can occur during the period from conception through several months after childbirth. Onset and course are not well understood. There is a paucity of longitudinal studies of the disorder that include the antenatal period in population-based samples. We used an Internet panel of pregnant women recruited in 2 cohorts; 858 ascertained in the first and 322 ascertained in the third trimesters of pregnancy. We recruited the second cohort in order to assure sufficient sample to examine depressive symptoms later in pregnancy and in the postpartum period. Assessments included standard psychometric measures, health history, and pregnancy experience. The Edinburgh Postnatal Depression Scale was used for the assessment of depressive symptoms. Nearly 10% of women entered the pregnancy with depressive symptoms. Prevalence was about the same at 4 weeks and 3 months postpartum. During pregnancy, prevalence increased to 16% in the third trimester. Among incident cases, 80% occurred during pregnancy, with 1/3 occurring in the first trimester. We describe predictors of incident depressive symptoms and covariates associated with time-to-onset which include health history (psychiatric and medical) and social support covariates. The majority of incident depressive symptoms occur during pregnancy rather than afterward. This finding underscores the mandate for mental health screening early in pregnancy and throughout gestation. It will be important to find safe and effective interventions that prevent, mitigate, or delay the onset of depressive symptoms that can be implemented during pregnancy.

Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy

“…The prevalence of depression in this population at such an early stage of pregnancy suggests that screening should occur at pregnancy diagnosis rather than at the first prenatal appointment, as the latter will miss individuals who experience miscarriage or who obtain an abortion. An analysis of individuals through pregnancy and the postpartum period reported that 80% of new perinatal depression diagnoses occurred during pregnancy rather than postpartum, 44 further highlighting the need for prenatal screening and detection of depression.…”

Psychological Investigation on Pregnant Women during the Outbreak of COVID-19

“…3 Furthermore, a number of studies demonstrated that nearly 80% of depressive symptoms (with an Edinburgh Postnatal Depression Scale (EPDS) score of 14 or higher) occur during pregnancy, rather than postpartum. 4 To our knowledge, pregnant women are susceptible to respiratory pathogens and develop severe pneumonia, which may make them more susceptible to COVID-19 infection than general people. Pregnant women and newborn babies should be taken high-risk groups into consideration in strategies focusing on the prevention and management of COVID-19 infection.…”

Psychological Investigation on Pregnant Women during the Outbreak of COVID-19

“…3 Furthermore, a number of studies demonstrated that nearly 80% of depressive symptoms (with an Edinburgh Postnatal Depression Scale (EPDS) score of 14 or higher) occurred during pregnancy, rather than postpartum. 4 To our knowledge, pregnant women are susceptible to respiratory pathogens and develop severe pneumonia, which may make them more susceptible to COVID-19 infection than general people. Pregnant women and newborn babies should be taken high-risk groups into consideration in strategies focusing on the prevention and management of COVID-19 infection .…”