Prevalence of Depression during Pregnancy in Spanish Women: Trajectory and Risk Factors in Each Trimester.

M. Belén Vázquez,M. Carmen Míguez

doi:10.3390/ijerph18136789

Abstract

The aims of this research were to determine the trajectories of probable depression and major depression during pregnancy and to identify the associated and predictor variables (sociodemographic, pregnancy-related, and psychological) for both conditions in each trimester of pregnancy. A longitudinal study was carried out with 569 pregnant Spanish women who were assessed in the first, second, and third trimesters of pregnancy. Depression was assessed using the Edinburgh Postnatal Depression Scale and a clinical interview. Measures of anxiety and stress were also included. The prevalence of probable depression in the first, second, and third trimesters was 23.4%, 17.0%, and 21.4%, respectively, and that of major depression was 5.1%, 4.0%, and 4.7%. Thus, the prevalence of both conditions was the highest in the first and third trimesters. The trajectories of probable depression and major depression followed the same pattern throughout pregnancy. All of the psychological variables studied were associated with both conditions in all three trimesters, with perceived stress being a predictor at all times. The association between the other variables and both conditions of depression was similar. Two exceptions stand out: having had previous miscarriages, which was only associated with probable depression and was also a predictor, in the first trimester; and complications during pregnancy, which was only associated with probable and major depression in the third trimester. These findings should be taken into account in routine pregnancy follow-ups, and necessary interventions should be started in the first trimester.

Highlights

Depression is one of the most prevalent psychological disorders, affecting women at twice the rate of men [1]
The prevalence of probable depression ranged from 17.0% to 23.4%, and the prevalence of major depression ranged from 4.0%
The study findings enabled us to determine which variables should be assessed routinely in order to enable the necessary help to be offered at each stage, to predict which women are at the greatest risk of developing depression in pregnancy, and to develop specific interventions at the most appropriate time to prevent depression from extending to the postpartum period

Summary

Introduction

Depression is one of the most prevalent psychological disorders, affecting women at twice the rate of men [1]. Vulnerability to depression is high during pregnancy and in the postpartum period [2], as the birth of a child is a life event associated with numerous biological, hormonal, psychological, familial, and social changes. Antenatal depression has received less attention than postpartum depression [3], as pregnancy was traditionally thought to protect women against the onset or relapse of depressive disorders. Depression during pregnancy has important consequences, both for mothers and their children. The main consequence of antenatal depression for mothers is a continuation of the state into the postpartum period, as depression in pregnancy is the main risk factor for postpartum depression [4,5,6]. Children of mothers with antenatal depression have been found to be more likely to have intrauterine growth retardation [7], be born preterm [7,8,9,10], and be small for gestational age [9,10], all of which are major causes of neonatal and infant morbidity and mortality

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Discussion

Conclusion