Abstract
Social support before and after childbirth is a possible protective factor for perinatal depression. Currently, there is a lack of longitudinal studies beyond the first year postpartum exploring the relationship of social support with depression and anxiety. Social support is also a possible protective factor for adverse child development, which is a known consequence of perinatal depression. The present study followed up a cohort of depressed women (n = 54) from a randomised controlled trial of psychological treatment for antenatal depression. We examined the trajectory of the relationships between perceived social support (Social Provisions Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory) twice in pregnancy and twice postpartum up to two years. The influence of social support on child development and parenting-related stress was also explored. Two aspects of social support, Reassurance of Worth and Reliable Alliance, were strongly related to perinatal depression and anxiety, particularly when predicting symptoms in late pregnancy. However, the effect of postnatal depression on child development at 9 and 24 months post-birth was not mediated by social support. These results suggest the importance of adjusting current interventions for depressed perinatal women to focus on social support in late pregnancy and the first six months postpartum.
Highlights
Social support has been shown to play a protective role against depression in the general population [1,2,3]
This study was a secondary analysis of data from a previously reported [37] parallel two-group randomised controlled trial (RCT) comparing cognitive behavioural therapy (CBT) treatment for antenatal depression and anxiety to treatment as usual (TAU)
As reported in the follow-up study, inspection of the same characteristics for the sub-set of the 28 women who returned data in the two-year follow-up revealed that the variables appeared to have remained reasonably well balanced between the CBT and TAU groups, with no significant differences between groups
Summary
Social support has been shown to play a protective role against depression in the general population [1,2,3]. The role of social support in the perinatal period has been of particular interest as a possible protective factor for coping difficulties arising from the many challenges that motherhood brings [4,5,6,7]. Previous studies have pointed to a link between social support and perinatal depression. Postnatal depression is inversely associated with social support [11,12,13,14]. The majority of studies have been cross-sectional, with only a few longitudinal studies demonstrating a relationship between social support and depressive symptoms. Leahy-Warren and colleagues [15] followed postnatal women to three months postpartum, and Brown and colleagues [16]
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