Depressive symptoms remain stable during pregnancy, up to 2 years after childbirth

Key takeaways:

• All mothers in this study had stable low, mild or high depressive symptoms throughout pregnancy and up to 2 years postpartum.
• Those with clinical depressive symptoms had stable trajectories throughout pregnancy.

Maternal depressive symptom trajectories remained stable throughout pregnancy and up to 2 years after childbirth, which suggests focusing not only on postpartum depression but depression throughout pregnancy, researchers reported.

“Because maternal depression has serious long-term implications on the child, it is essential to clearly define when depressive symptoms first emerge to inform timely interventions,” Michelle Z. L. Kee, PhD, research scientist in the department of translational neuroscience at the Singapore Institute for Clinical Sciences at the Agency for Science, Technology and Research, Singapore, and colleagues wrote.

Kee and colleagues conducted a cohort study, published in JAMA Network Open, with 11,563 pregnant women (mean age, 29 years) from seven prospective cohorts from the U.K., Canada and Singapore who self-reported depressive symptoms at multiple time points. These cohorts included the United Kingdom Avon Longitudinal Study of Parents and Children; Canada Alberta Pregnancy Outcomes and Nutrition Study; Maternal Adversity, Vulnerability and Neurodevelopment Study; Montreal Antenatal Well-Being Study; Singapore Growing Up in Singapore Toward Healthy Outcomes; Singapore Preconception Study of Long-Term Maternal and Child Outcomes; and Mapping Antenatal Maternal Stress.

All participants were recruited during preconception or pregnancy and followed into the postnatal period. Using the Edinburgh Postnatal Depression Scale or the Center for Epidemiological Studies-Depression scale, participants self-reported depressive symptoms from pregnancy to 2 years postpartum.

In the cohort, 87.6% of women were white, 4.9% were East Asian and 2.6% were Southeast Asian. Researchers categorized all participants based on level of self-reported depressive symptoms as low, mild or high. All participants had stable depressive symptom trajectories from pregnancy to 2 years postpartum. Those with clinical depressive symptom levels, which were women with probable depression at any time point defined by an Edinburgh Postnatal Depression Scale score of 15 or more during pregnancy and/or 13 or more after giving birth, had stable trajectories from pregnancy into the postnatal period.

“These findings suggest that studies focusing uniquely on postpartum depression miss the optimal timing for examining determinants and intervention benefits for both mother and child,” the researchers wrote. “Indeed, recent analyses suggest that maternal depressive symptoms may often predate conception, highlighting a potentially critical further topic for public health policy revisions.”