Abstract
Depression during pregnancy (prenatal depression) is common and has important consequences for mother and child. Evidence suggests an increasing prevalence of depression, especially in young women. It is unknown whether this is reflected in an increasing prevalence of prenatal depression. To compare the prevalence of depression during pregnancy in today's young mothers with their mothers' generation. In a longitudinal cohort study, we compared prenatal depressive symptoms in 2 generations of women who participated in the Avon Longitudinal Study of Parents and Children. Participants were the original mothers (recruited when they were pregnant) and their female offspring, or female partners of male offspring, who became pregnant. Both groups were limited to the same age range (19-24 years). The first generation of pregnancies occurred in 1990 to 1992 (n = 2390) and the second in 2012 to 2016 (n = 180). In both generations, women were born in the same geographical area (southwest England). Depressed mood measured prenatally using the Edinburgh Postnatal Depression Scale in self-reported surveys in both generations. A score of 13 or greater on a scale of 0 to 30 indicated depressed mood. Of 2390 pregnant women in the first generation who were included in analysis (mean [SD] age, 22.1 [2.5] years), 408 (17%) had high depressive symptom scores (≥13). Of 180 pregnant women in the second generation who were included in the analysis (mean [SD] age, 22.8 [1.3] years), 45 (25%) had high depressive symptom scores. Having high depressive symptom scores was more common in the second generation of young pregnant women than in their mothers' generation (relative risk, 1.51; 95% CI, 1.15-1.97), with imputation for missing confounding variable data and adjustment for age, parity, education, smoking, and body mass index not substantially changing this difference. Results were essentially the same when analyses were restricted to the 66 mother-offspring pairs. Maternal prenatal depression was associated with daughters' prenatal depression (relative risk, 3.33; 95% CI, 1.65-6.67). In this unique study of 2 generations of women who answered identical questionnaires in pregnancy, evidence was found that depressed mood may be higher in young pregnant women today than in their mothers' generation. Because of the multiple and diverse consequences of prenatal depression, an increase in prevalence has important implications for families, health care professionals, and society.
Highlights
Depression has previously been estimated to affect approximately 10% to 15% of pregnant women,[1] a similar magnitude to that found among postnatal women.[2]
Having high depressive symptom scores was more common in the second generation of young pregnant women than in their mothers’ generation, with imputation for missing confounding variable data and adjustment for age, parity, education, smoking, and body mass index not substantially changing this difference
Maternal prenatal depression was associated with daughters’ prenatal depression
Summary
Depression has previously been estimated to affect approximately 10% to 15% of pregnant women,[1] a similar magnitude to that found among postnatal women.[2]. There is evidence from routine data and population surveys that psychiatric service use and antidepressant prescriptions have increased in recent years.[5,6] Whether these changes reflect less stigma and greater awareness of mental health, a genuine increase in overall population levels of depression, or both is unclear. Evidence from population surveys (including the UK Office for National Statistics surveys11) suggests that depression in young women (aged 19-24 years) is increasing more than depression in other gender and age groups.[9,10,11]
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