Prevalence of Prenatal Depression Symptoms Among 2 Generations of Pregnant Mothers

Pearson, Rebecca; Carnegie, Rebecca; Cree, Callum; Rollings, Claire; Rena-Jones, Louise; Evans, Jonathan; Stein, Alan; Tilling, Kate; Lewcock, Melanie; Lawlor, Debbie A.

doi:10.1001/jamanetworkopen.2018.0725

Cited by 78 publications

(78 citation statements)

References 25 publications

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“…However, it is likely to reflect at least in part a real increase, as similar findings of an increase of common men‐tal ‐disorders in young women has been found in population surveys 28 . Moreover, a multi‐generational pregnancy cohort 29 has reported that depression in pregnancy was on average 51% more common among young mothers in the recent generation than among their mothers' generation 25 years ago. We also recently reported a population prevalence estimate of common mental disorders of 45.1% (95% CI: 23.5‐68.7) in pregnant women less than 25 years of age, compared with 15.5% (95% CI: 12.0‐19.8) in women aged 25 years of more (adjusted odds ratio: 5.8, 95% CI: 1.8‐18.6) 30 .…”

Section: Prevalence Of Mental Disorders In the Perinatal Periodsupporting

confidence: 62%

“…Obviously, young pregnant women are now living in circumstances different from their mothers: some have pointed to the fast pace of modern life, changes in technology (including social media use which may amplify experiences of abuse and bullying through “sexting”), isolation, and insecure employment as potential contributors to this 29 .…”

Section: Prevalence Of Mental Disorders In the Perinatal Periodmentioning

confidence: 99%

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Perinatal mental health: a review of progress and challenges

2020

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Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high‐income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also need additional support for parenting. The evidence base on psychotropic use in pregnancy is almost exclusively observational. There is little research on the full range of perinatal mental disorders, on how to improve access to treatment for women with psychosocial difficulties, and on the effectiveness of different service delivery models. We conclude with research and clinical implications, which, we argue, highlight the need for an extension of generic psychiatric services to include preconception care, and further investment into public health interventions, in addition to perinatal mental health services, potentially for women and men, to reduce maternal and child morbidity and mortality.

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Section: Prevalence Of Mental Disorders In the Perinatal Periodsupporting

confidence: 62%

Section: Prevalence Of Mental Disorders In the Perinatal Periodmentioning

confidence: 99%

Perinatal mental health: a review of progress and challenges

2020

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“…It is also a major risk factor of suicide, one of the most common causes of death among women during the perinatal period (Chang, Berg, Saltzman, & Herndon, 2005;Nock et al, 2008). In addition to the women themselves, perinatal depression affects their children: prenatal depression is associated with developmental adversities, including increased risk of low birth weight and preterm birth (Pesonen et al, 2016). Both prenatal and postpartum depression (PPD) are associated with lower rates and shorter duration of breastfeeding (Figueiredo, Canário, & Field, 2014), less secure mother-child attachment (Martins & Gaffan, 2000), and higher risk of child neurodevelopmental, emotional, and behavioral problems (Lahti et al, 2017;Toffol et al, 2019;Tuovinen et al, 2018;Wolford et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…While the risk of perinatal depression is modified by psychosocial (Yim, Tanner Stapleton, Guardino, Hahn-Holbrook, & Dunkel Schetter, 2015) and hormonal (Schiller, Meltzer-Brody, & Rubinow, 2015) factors, twin (Treloar, Martin, Bucholz, Madden, & Heath, 1999;Viktorin et al, 2016), sibling (Murphy-Eberenz et al, 2006;Viktorin et al, 2016) and family (Forty et al, 2006;Pearson et al, 2018) studies indicate that heritable factors also play a part. Heritability estimates of perinatal depression have varied between 25% (Treloar et al, 1999) and 54% (Viktorin et al, 2016) in twin studies, and 44% (Viktorin et al, 2016) in a sibling study.…”

Section: Introductionmentioning

confidence: 99%

Polygenic prediction of the risk of perinatal depressive symptoms

Rantalainen

Binder

Lahti‐Pulkkinen

et al. 2020

Depression and Anxiety

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Background Perinatal depression carries adverse effects on maternal health and child development, but genetic underpinnings remain unclear. We investigated the polygenic risk of perinatal depressive symptoms. Methods About 742 women from the prospective Prediction and Prevention of Pre‐eclampsia and Intrauterine Growth Restriction cohort were genotyped and completed the Center for Epidemiologic Studies Depression scale 14 times during the prenatal period and twice up to 12 months postpartum. Polygenic risk scores for major depressive disorder, bipolar disorder, schizophrenia, and cross‐disorder were calculated using multiple p‐value thresholds. Results Polygenic risk scores for major depressive disorder, schizophrenia, and cross‐disorder, but not bipolar disorder, were associated with higher prenatal and postpartum depressive symptoms (0.8%–1% increase per one standard deviation increase in polygenic risk scores). Prenatal depressive symptoms accounted for and mediated the associations between the polygenic risk scores and postpartum depressive symptoms (effect size proportions‐mediated: 52.2%–88.0%). Further, the polygenic risk scores were associated with 1.24–1.45‐fold odds to belong to the group displaying consistently high compared with consistently low depressive symptoms through out the prenatal and postpartum periods. Conclusions Polygenic risk scores for major depressive disorder, schizophrenia, and cross‐disorder in non‐perinatal populations generalize to perinatal depressive symptoms and may afford to identify women for timely preventive interventions.

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“…3 There is evidence that the proportion of women taking antidepressants during pregnancy has increased substantially in recent years; 4 for example from 2% in 1991-1992 to 13% in 2012-2016 in a two-generational study of young mothers in southwest England. 5 National Institute for Health and Care Excellence (NICE) guidelines recommend a stepped-care approach to the assessment and management of perinatal depression, with first-line management in primary care. 6 This includes first-line management of antidepressant use in pregnancy, in consultation with experts where necessary.…”

Section: Introductionmentioning

confidence: 99%

Patient decision aids for antidepressant use in pregnancy: a pilot randomised controlled trial in the UK

et al. 2019

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BackgroundDecision-making regarding antidepressant use in pregnancy is challenging, given the uncertain evidence base on the benefits and risks for women and their children. Patient decision aids (PDAs) can improve shared decision-making for complex health decisions but no evidence-based PDAs exist for antidepressant use in pregnancy.AimTo assess the feasibility of a full-scale randomised controlled trial (RCT) to evaluate the efficacy of an electronic PDA on antidepressant use in pregnancy.Design & settingA UK-based pilot parallel-group RCT.MethodThe study recruited women whose clinicians recommended an antidepressant for depression in a current or planned pregnancy, and who were uncertain about antidepressant use while pregnant. Women were recruited via clinician or self-referral, and randomised to online access to the PDA or online access to standard resource list, with primary follow-up at 4 weeks and longer-term follow-up. The primary outcome was protocol feasibility (recruitment target of 50 women and follow-up rate of 80%). Outcome measures for a future full-scale RCT included the decisional conflict scale (DCS).ResultsFifty-one women were recruited with a follow-up rate of 90.2% at 4 weeks. The PDA received good overall satisfaction ratings (mean 4.2/5). Analysis of covariance (ANCOVA) indicated a small improvement in decisional conflict at 4 weeks, accounting for baseline scores (DCS regression coefficient = -3.5, 95% confidence intervals [CI = -12.6 to 5.6]).ConclusionThis pilot RCT for an electronic PDA on antidepressant use in pregnancy showed that the study protocol was feasible, with high rates of participant satisfaction among those randomised to the PDA.

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Prevalence of Prenatal Depression Symptoms Among 2 Generations of Pregnant Mothers

Cited by 78 publications

References 25 publications

Perinatal mental health: a review of progress and challenges

Perinatal mental health: a review of progress and challenges

Polygenic prediction of the risk of perinatal depressive symptoms

Patient decision aids for antidepressant use in pregnancy: a pilot randomised controlled trial in the UK

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