Lifetime prevalence and correlates of perinatal depression in a case-cohort study of depression
Jacqueline Kiewa1, Samantha Meltzer-Brody2, Jeannette Milgrom3,4
1Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia j.kiewa@uq.edu.au.
Insights
Perinatal depression (PND) affects 70% of women with a history of depression, often presenting with antenatal and postnatal symptoms. Early assessment is crucial, especially for those with prior depression or adverse experiences.
Area of Science:
- Reproductive Medicine
- Psychiatry
- Genetics
Background:
- Perinatal depression (PND) is a significant concern affecting women during pregnancy and postpartum.
- Understanding the prevalence and correlates of PND is vital for effective intervention.
- A history of depression may influence the presentation and course of perinatal mood disorders.
Purpose of the Study:
- To evaluate the prevalence, onset, and duration of PND symptoms in women with depression.
- To compare PND in women with and without a prior history of depression.
- To identify biopsychosocial factors associated with PND.
Main Methods:
- An online case cohort study (Australian Genetics of Depression Study) of women with major depressive disorder.
- Comparison of parous women with PND and those with lifetime depression but no perinatal symptoms.
- Utilized the Edinburgh Postnatal Depression Scale for screening.
Main Results:
- PND prevalence was 70% among parous women with lifetime depression.
- Most women experienced PND symptoms both antenatally and postnatally.
- Prior depression history was linked to increased PND episodes, non-European ancestry, severe nausea, and emotional abuse.
Conclusions:
- The majority of women with lifetime depression experience PND, indicating a more complex and severe condition.
- Perinatal assessments for depressive symptoms are essential.
- Women with a history of depression or childhood adversity require particular attention during perinatal periods.
Objectives:
This study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression.
Design And Setting:
The Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms.
Participants:
In a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively).
Primary And Secondary Outcome Measures:
The primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures.
Results:
The prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, p<0.001), non-European ancestry (OR 1.5, 95% CI 1.0 to 2.1, p=0.03), severe nausea during pregnancy (OR 1.3, 95% CI 1.1 to 1.6, p=0.006) and emotional abuse (OR 1.4, 95% CI 1.1 to 1.7, p=0.005).
Conclusions:
The majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.
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