Stressful Events During Pregnancy and Postpartum Depressive Symptoms

Abstract

Background: Understanding the influence of perinatal stressors on the prevalence of postpartum depressive symptoms (PDS) and help-seeking for PDS using surveillance data can inform service provision and improve health outcomes. Methods: We used Massachusetts Pregnancy Risk Assessment Monitoring System (MA-PRAMS) 2007-2010 data to evaluate associations between selected perinatal stressors and PDS and with subsequent help-seeking behaviors. We categorized 12 stressors into 4 groups: partner, traumatic, financial, and emotional. We defined PDS as reporting ''always'' or ''often'' to any depressive symptoms on PRAMS Phase 5, or to a composite score ‡ 10 on PRAMS Phase 6 depression questions, compared with women reporting ''sometimes,'' ''rarely'' or ''never'' to all depressive symptoms. The median response time to MA-PRAMS survey was 3.2 months (interquartile range, 2.9-4.0 months). We estimated prevalence ratios (PRs) and 95% confidence intervals (95% CIs) using modified Poisson regression models, controlling for socioeconomic status indicators, pregnancy intention and prior mental health visits. Results: Among 5,395 participants, 58% reported ‡ 1 stressor (partner = 26%, traumatic = 16%, financial = 29% and emotional = 30%). Reporting of ‡ 1 stressor was associated with increased prevalence of PDS (PR = 1.68, 95% CI: 1.42-1.98). The strongest association was observed for partner stress (PR = 1.90, 95% CI: 1.51-2.38). Thirty-eight percent of mothers with PDS sought help. Mothers with partner-related stressors were less likely to seek help, compared with mothers with other grouped stressors. Conclusions: Women who reported perinatal common stressors-particularly partner-related stressors-had an increased prevalence of PDS. These data suggest that women should be routinely screened during pregnancy for a range of stressors and encouraged to seek help for PDS.

The birth of new neurons in the maternal brain: Hormonal regulation and functional implications

“…Indeed, postpartum depression represents one of the most common complications following childbirth and has been estimated to affect up to 20% of new mothers (O’Hara and McCabe, 2013; Wisner et al, 2013; Agrati and Lonstein, 2015; Brummelte and Galea, 2015). A number of factors have been identified that may increase the risk of postpartum depression (Robertson et al, 2004; Stone et al, 2015), including stress during pregnancy and/or after birth which can be easily modeled in rodents (Perani and Slattery, 2014). For example, a growing body of research has revealed that repeated exposure to stress while pregnant can induce behavioral despair and impaired maternal care during the postpartum period (Smith et al, 2004; O’Mahony et al, 2006; Haim et al, 2014; Leuner et al, 2014), thus acting as a model of postpartum depression.…”

Implications of Polymorphisms in the CRHR1 Gene on the Hypothalamic-Pituitary-Adrenal Axis Functioning in Postpartum Depression

“…The occurrence of stressors during the lifespan has been described as an important risk factor for depressive disorders [51,52], including peripartum depressive episodes [53,54]. The CRHR1 polymorphisms seem to modulate the sensitivity to stress, probably through their role in the regulation of HPA axis function, increasing the risk of depression [29,55]; but, unfortunately, our data do not allow us to establish causal relationships.…”

Women’s mental health following the birth of a child: a life course approach

“…Studies suggest it is relatively common for pregnant women to report the experience of stressful life events (Brown et al, 2011, Meijer et al, 2014, Stone et al, 2015. In a large, randomly selected sample of women, 17.0% reported having three or more stressful life events in the one year prior to their baby's birth .…”