Trajectories of maternal depressive symptoms from the antenatal period to 24-months postnatal follow-up: findings from the 2015 Pelotas birth cohort

Nadège Jacques,Andréa Dâmaso Bertoldi,Mariangela Freitas Silveira,Alicia Matijasevich,Marlos Rodrigues Domingues,Alan Stein,Marilia Arndt Mesenburg

doi:10.1186/s12888-020-02533-z

Nadège Jacques, Andréa Dâmaso Bertoldi + Show 5 more

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https://doi.org/10.1186/s12888-020-02533-z

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Abstract

BackgroundMaternal depression may be chronic and recurrent, with negative effects both on the health of mothers and children. Many studies have shown trajectories of postnatal depressive symptoms but few studies in low- and middle-income countries have evaluated the trajectories of depressive symptoms starting during pregnancy. This study aims to identify the different trajectories of depressive symptoms among mothers in the Pelotas 2015 birth cohort, from pregnancy to the second year of the child’s life.MethodsThis study used data from the 2015 Pelotas Birth Cohort, a longitudinal study of all live births occurred in 2015 in Pelotas, Brazil. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers who completed the EPDS on at least three follow-up visits beginning to the antenatal follow-up visit were included in the analyses. The trajectory of maternal depressive symptoms was estimated through group-based trajectory modeling.ResultsA total of 3040 women were included in the present analysis. We identified five groups of maternal depressive symptoms trajectories, with 23.4% of the mothers presenting persistent depressive symptoms and 3.9% showing chronic high depressive symptoms throughout the study period. The probability of having persistent depressive symptoms increased among mothers with greater socioeconomic vulnerability.ConclusionsThis study shown the persistence of maternal depressive symptoms since pregnancy until 2 years postnatal. Additionally, alongside the known risk factors, pre-gestational depression and antenatal depressive symptoms are important risk factors for the persistence and severity of depressive symptoms. These findings support the need to provide mental health evaluation and care for women from pregnancy to the late postnatal period.

Highlights

Maternal depression may be chronic and recurrent, with negative effects both on the health of mothers and children
Antenatal depression is a major predictor of postnatal depression [9,10,11], with other associated factors: living alone, having more than two children, low education, and unemployment [8, 12]
Few studies have analyzed trajectories of maternal depression including pre- and postnatal periods, and some study specific low income populations within high-income countries [17] but none in low- or middle-income countries This is consistent with the research gap on the trajectories of depression in low- and middle-income countries, which may be different [18, 19]

Summary

Introduction

Maternal depression may be chronic and recurrent, with negative effects both on the health of mothers and children. This study aims to identify the different trajectories of depressive symptoms among mothers in the Pelotas 2015 birth cohort, from pregnancy to the second year of the child’s life. Maternal depressive symptoms may be chronic or recurrent, and have major consequences for the health of mothers and children [8, 13,14,15]. Few studies have analyzed trajectories of maternal depression including pre- and postnatal periods, and some study specific low income populations within high-income countries [17] but none in low- or middle-income countries This is consistent with the research gap on the trajectories of depression in low- and middle-income countries, which may be different [18, 19]

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