Pregnancy and post-partum depression and anxiety in a longitudinal general population cohort: The effect of eating disorders and past depression

Abstract

BackgroundThis study investigated the effect of past depression, past and current eating disorders (ED) on perinatal anxiety and depression in a large general population cohort of pregnant women, the Avon Longitudinal Study of Parents and Children (ALSPAC). MethodsAnxiety and depression were measured during and after pregnancy in 10,887 women using the Crown-Crisp Experiential Inventory and Edinburgh Postnatal Depression Scale. Women were grouped according to depression and ED history: past ED with (n=123) and without past depression (n=50), pregnancy ED symptoms with (n=77) and without past depression (n=159), past depression only (n=818) and controls (n=9,660). We compared the course of depression and anxiety with linear mixed-effect regression models; and probable depressive and anxiety disorders using logistic regression. ResultsWomen with both past depression and past/current ED had high anxiety and depression across time perinatally; this was most marked in the group with pregnancy ED symptoms and past depression (b coefficient:5.1 (95% CI: 4.1–6.1), p<0.0001), especially at 8months post-partum. At 18weeks in pregnancy all women (apart from those with past ED only) had a higher risk for a probable depressive and anxiety disorder compared to controls. At 8months post-partum pregnancy ED symptoms and/or past depression conferred the highest risk for a probable depressive and anxiety disorder. LimitationsData were based on self-report. There was some selective attrition. ConclusionsPregnancy ED symptoms and past depression have an additive effect in increasing the risk for depression and anxiety perinatally. Screening at risk women for anxiety and depression in the perinatal period might be beneficial.