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. 2021 Feb;24(1):119-131.
doi: 10.1007/s00737-020-01017-z. Epub 2020 Feb 4.

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

Marsha Wilcox  1 , Beth Ann McGee  2 , Dawn F Ionescu  3 , Marie Leonte  2 , Lauren LaCross  2 , Jenna Reps  4 , Kevin Wildenhaus  4
Affiliations

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

Marsha Wilcox et al. Arch Womens Ment Health. 2021 Feb.

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.

Keywords: EPDS; Internet research; Longitudinal study; Perinatal depression.

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Conflict of interest statement

All authors are employees of Johnson & Johnson. Baby Center was a Johnson & Johnson entity at the time this work was done.

Figures

Fig. 1
Fig. 1
Completion rates by time period and cohort
Fig. 2
Fig. 2
Cohort 1: incident depressive symptoms during pregnancy and postpartum periods
Fig. 3
Fig. 3
Time-to-onset curves for selected covariates
See this image and copyright information in PMC

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