The Socioemotional Development of 5-year-old Children of Postnatally Depressed Mothers

Objective To follow mothers' mood through pregnancy and after childbirth and compare reported symptoms of depression at each stage. Design Longitudinal cohort study. Setting Avon. Participants Pregnant women resident within Avon with an expected date of delivery between 1 April 1991 and 31 December 1992. Main outcome measures Symptom scores from the Edinburgh postnatal depression scale at 18 and 32 weeks of pregnancy and 8 weeks and 8 months postpartum. Proportion of women above a threshold indicating probable depressive disorder. Results Depression scores were higher at 32 weeks of pregnancy than 8 weeks postpartum (difference in means 0.88, 95% confidence interval 0.79 to 0.97). There was no difference in the distribution of total scores or scores for individual items at the four time points. 1222 (13.5%) women scored above threshold for probable depression at 32 weeks of pregnancy, 821 (9.1%) at 8 weeks postpartum, and 147 (1.6%) throughout. More mothers moved above the threshold for depression between 18 weeks and 32 weeks of pregnancy than between 32 weeks of pregnancy and 8 weeks postpartum. Conclusions Symptoms of depression are not more common or severe after childbirth than during pregnancy. Research and clinical efforts need to be moved towards understanding, recognising, and treating antenatal depression.

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“…However, the more common consequences include emotional and behavioural problems, and cognitive delay in the children of depressed mothers. 5 6…”

Section: Introductionmentioning

confidence: 99%

Cohort study of depressed mood during pregnancy and after childbirth

Evans

Heron

Francomb

et al. 2001

BMJ

1,101

680

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“…In high-income settings, infants of women with postnatal CMD are more likely to have impaired cognitive, social and emotional development 1–3. Maternal health behaviours on behalf of their infants may also be negatively affected by maternal CMD: decreased vaccination, impaired child safety behaviours4 and increased use of emergency5–7 rather than preventive services 7…”

Section: Introductionmentioning

confidence: 99%

Perinatal mental distress and infant morbidity in Ethiopia: a cohort study

Ross

Hanlon

Medhin

et al. 2010

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Objectives(1) To investigate the impact of perinatal common mental disorders (CMD) in Ethiopia on the risk of key illnesses of early infancy: diarrhoea, fever and acute respiratory illnesses (ARI) and (2) to explore the potential mediating role of maternal health behaviours.DesignPopulation-based cohort study.SettingDemographic surveillance site in a predominantly rural area of Ethiopia.Participants1065 women (86.3% of eligible) in the third trimester of pregnancy were recruited and 954 (98.6%) of surviving, singleton mother–infant pairs were followed up until 2 months after birth.Main exposure measureHigh levels of CMD symptoms, as measured by the locally validated Self-Reporting Questionnaire (SRQ-20 ≥6), in pregnancy only, postnatally only and at both time-points (‘persistent’).Main outcome measuresMaternal report of infant illness episodes in first 2 months of life.ResultsThe percentages of infants reported to have experienced diarrhoea, ARI and fever were 26.0%, 25.0% and 35.1%, respectively. Persistent perinatal CMD symptoms were associated with 2.15 times (95% CI 1.39 to 3.34) increased risk of infant diarrhoea in a fully adjusted model. The strength of association was not affected by including potential mediators: breast feeding practices, hygiene, the infant's vaccination status or impaired maternal functioning. Persistent perinatal CMD was not associated with infant ARI or fever after adjusting for confounders.ConclusionsPersistent perinatal CMD was associated with infant diarrhoea in this low-income country setting. The observed relationship was independent of maternal health-promoting practices. Future research should further explore the mechanisms underlying the observed association to inform intervention strategies.

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“…1 Postnatal depression is an important category of depression, with over 11% of women experiencing major or minor postnatal depression six weeks postnatally. 2 There is now considerable evidence to show that postnatal depression has a substantial impact on the mother and her partner, 3 the family, 4 motherbaby interactions, 5 and the longer term emotional and cognitive development of the baby, 6 especially when depression occurs in the first year of life. 7 Though clinically and cost effective treatments are available, 8 9 less than half of cases of postnatal depression are detected in routine clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Screening for postnatal depression in primary care: cost effectiveness analysis

Paulden

Palmer

Hewitt

et al. 2009

BMJ

103

114

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Objective To evaluate the cost effectiveness of routine screening for postnatal depression in primary care. Design Cost effectiveness analysis with a decision model of alternative methods of screening for depression, including standardised postnatal depression and generic depression instruments. The performance of screening instruments was derived from a systematic review and bivariate meta-analysis at a range of instrument cut points; estimates of other relevant parameters were derived from literature sources and relevant databases. A decision tree considered the full treatment pathway from the possible onset of postnatal depression through identification, treatment, and possible relapse. Setting Primary care. Participants A hypothetical population of women assessed for postnatal depression either via routine care only or supplemented by use of formal identification methods six weeks postnatally, as recommended in recent guidelines. Main outcome measures Costs expressed in 2006-7 prices and impact on health outcomes expressed in terms of quality adjusted life years (QALYs). The time horizon of the analysis was one year. Results The routine application of either postnatal or general depression questionnaires did not seem to be cost effective compared with routine care only. The Edinburgh postnatal depression scale (at a cut point of 16) had an incremental cost effectiveness ratio (ICER) of £41 103 (€45 398, $67 130) per QALY compared with routine care only. The ICER for all other strategies ranged from £49 928 to £272 463 per QALY versus routine care only, while the probability that no formal identification strategy was cost effective was 88% (59%) at a cost effectiveness threshold of £20 000 (£30 000) per QALY. While sensitivity analysis indicated that the cost of managing incorrectly identified depression (false positive result) was an important driver of the model, formal identification approaches did not seem to be cost effective at any feasible estimate of this cost. Conclusions Formal identification methods for postnatal depression do not seem to represent value for money for the NHS. The major determinant of cost effectiveness seems to be the potential additional costs of managing women incorrectly diagnosed as depressed. Formal identification methods for postnatal depression do not currently satisfy the National Screening Committee's criteria for the adoption of a screening strategy as part of national health policy. INTRODUCTIONDepression accounts for the greatest burden among all mental health problems and by 2020 is expected to become the second most common general health problem.1 Postnatal depression is an important category of depression, with over 11% of women experiencing major or minor postnatal depression six weeks postnatally.2 There is now considerable evidence to show that postnatal depression has a substantial impact on the mother and her partner, 3 the family, 4 motherbaby interactions, 5 and the longer term emotional and cognitive development of the baby, 6 especially when depress...

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The Socioemotional Development of 5-year-old Children of Postnatally Depressed Mothers

Cited by 138 publications

References 33 publications

Cohort study of depressed mood during pregnancy and after childbirth

Cohort study of depressed mood during pregnancy and after childbirth

Perinatal mental distress and infant morbidity in Ethiopia: a cohort study

Screening for postnatal depression in primary care: cost effectiveness analysis

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