Depressive Symptoms In Late Pregnancy Research Articles

Effect of biological, psychological, and social factors on maternal depressive symptoms in late pregnancy: a cross-sectional study.

Depression commonly occurs during pregnancy and has become a major public health concern. Depression not only affects the individual but also causes adverse consequences for families and children. However, little is known regarding the depression status and its influencing factors in women during late pregnancy in China. This study aimed to assess the prevalence of maternal depressive symptoms in late pregnancy during the coronavirus disease 2019 (COVID-19) pandemic and further explore the effect of biological, psychological, and social factors on depressive symptoms. An institution-based cross-sectional survey was conducted among eligible women in the late pregnancy stage and underwent prenatal examination at Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China from December 2022 to February 2023. Data regarding depressive symptoms and biological, psychological, and social factors of the pregnant women were collected via a structured questionnaire. Chi-square test, Fisher's exact tests, and binary logistics regression were used to analyze the data. In total, 535 women in the late pregnancy stage were included in this study, 75 (14.0%) of whom exhibited depressive symptoms. A binary logistic regression analysis revealed that pregnant women who were multiparous (OR: 2.420, 95% CI: 1.188-4.932) and had moderate or severe insomnia symptoms (OR: 4.641, 95% CI: 1.787-12.057), anxiety (OR: 8.879, 95% CI: 4.387-17.971), high fear of COVID-19 (OR: 2.555, 95% CI: 1.255-5.199), moderate or severe family dysfunction (OR: 2.256, 95% CI: 1.141-4.461), and poor social support (OR: 2.580, 95% CI: 1.050-6.337) tended to show depressive symptoms. Conversely, pregnant women who received regular prenatal care (OR: 0.481, 95% CI: 0.243-0.951) and had good drinking water quality at home (OR: 0.493, 95% CI: 0.247-0.984) were more likely to avoid developing depressive symptoms. This study found that the prevalence of maternal depressive symptoms during late pregnancy was high and had multiple influencing factors. Thus, screening for depressive symptoms in women in the late pregnancy stage and providing special intervention programs are necessary, especially for those with risk factors.

Relationship between inflammatory biomarkers, vitamin D levels, and depressive symptoms in late pregnancy and during the postpartum period: a prospective, observational study

BackgroundPerinatal depression impacts maternal and fetal health, and exhibits a high rate of continuity postpartum. Not only does it impair the maternal quality of life, it also increases the risk of adverse birth and developmental problems in offspring. Vitamin D deficiency and excessive inflammation have been associated with perinatal depression. There is a scarcity of evidence regarding the biological causes of maternal depression in Iraq, therefore, the present study aims to assess perinatal depressive symptoms associations with inflammatory markers and vitamin D levels, and to investigate the interaction between vitamin D and the inflammatory markers. A prospective, observational study design was utilized to recruit healthy pregnant women from private obstetrics clinic in Baghdad, Iraq, from April to September 2021. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms during the third trimester and at 6 months postpartum. Serum levels of interleukin (IL)-6, C-reactive protein (CRP), and 25-hydroxy vitamin D (25-OH-D) were quantified, using a fully automated chemiluminescence immunoassay analyzer.ResultsEighty patients were eligible for inclusion. The antenatal EPDS scores demonstrated a significant association with square root IL-6 (B = – 0.025, p = 0.040) and no association with CRP or vitamin D levels. The severity of postpartum depressive symptoms tended towards a positive association, with larger increases of CRP concentration (p = 0.065). In contrast, the association between marital relationship quality and CRP was statistically significant (p = 0.001). There was a statistically significant association between CRP and vitamin D concentration (p = 0.041). Antepartum EPDS significantly predicted the postpartum EPDS score (p = 0.000, B = 0.180, R2 for the model = 0.976, CI (0.17–0.19)).ConclusionsThe study findings show a significant association between third trimester depressive symptoms and IL-6 concentration. CRP and vitamin D levels do not correlate with perinatal depressive symptoms and a poor marital relationship significantly elevates the CRP level. In addition, vitamin D level was associated with CRP level and antepartum depressive symptoms predict postpartum EPDS score. Future studies involving a larger population and including women with pregnancy complications would provide a further insight into the role of inflammation and vitamin D deficiency in the etiology of perinatal depression.

Urinary metabolites as a predictive marker for perinatal depression: A secondary analysis of the mothers, Omega-3 & Mental Health Study

Background:Perinatal depression has been associated with unfavorable pregnancy and childhood development outcomes; however, no objective markers exist to identify perinatal mood disorders. We investigated whether metabolites in maternal urine during pregnancy can predict increased depressive symptoms in late pregnancy and postpartum among pregnant women at risk for perinatal depression.Methods:We evaluated metabolomic markers in urine collected at 12–20 and 34–36 weeks’ gestation. We analyzed 49 urinary metabolites using ion pairing reversed-phase liquid chromatography-mass spectrometry. Depressive symptom severity was identified using Beck Depression Inventory (BDI) scores from 105 participants at 12–20 and 34–36 weeks’ gestation, and 6–8 weeks’ postpartum. Mixed model repeated measures analysis evaluated associations between changes in maternal urinary metabolites and BDI scores across pregnancy.Results:Increases in urinary xanthine and hypoxanthine were positively associated with increases in maternal depressive symptoms throughout pregnancy (p = 0.03 and 0.02, respectively). This finding did not persist after false discovery rate correction. None of the urinary metabolites examined were significantly associated with development of postpartum depressive symptoms.Limitations:This study is an exploratory secondary biologic sample analysis from a trial whose sample size was determined by a different primary outcome and expected effect size, which may have limited statistical power to detect associations between urinary metabolites, depressive symptoms, and mood trajectory over time.Conclusions:Increasing concentrations of xanthine and hypoxanthine were associated with increasing depressive symptoms throughout pregnancy. Further research is needed to evaluate the utility of these metabolic markers in identifying women at risk for perinatal depressive symptoms.

Sleep Disordered Breathing Measures in Early Pregnancy Are Associated with Depressive Symptoms in Late Pregnancy.

Sleep disordered breathing (SDB) and depression are both common complications of pregnancy and increase risk for adverse maternal and neonatal outcomes. SDB precedes onset of depression in non-pregnant adults; however, the longitudinal relationship has not been studied in pregnancy. The present research examined temporal associations between SDB and depressive symptoms in 175 pregnant women at risk for SDB (based on frequent snoring and obesity), but without an apnea hypopnea index of ≥5 events per hour at enrollment. Women completed a self-report assessments of depressive symptoms using PHQ-9 and in-home level III sleep apnea monitoring at approximately 12- and 32-weeks’ gestation. We also assessed the risk for SDB using the Berlin Questionnaire in early pregnancy. Results revealed that measures of SDB in early pregnancy as assessed by in-home sleep study, but not by self-reported SDB, predicted elevated depressive symptoms in late pregnancy. SDB in late pregnancy was not associated with depressive symptoms. To conclude, these findings suggest that SDB may increase the risk for elevated depressive symptoms as pregnancy progresses.

Prenatal maternal depressive symptoms are associated with smaller amygdalar volumes of four-year-old children

Prenatal maternal depressive symptoms are related to an increased offspring susceptibility to psychiatric disorders over the life course. Alterations in fetal brain development might partly mediate this association. The relation of prenatal depressive symptoms with child's amygdalar volumes is still underexplored, and this study aimed to address this gap. We explored the association of prenatal maternal depressive symptoms with amygdalar volumes in 28 4-year-old children (14 female). Amygdalar volumes were assessed using the volBrain pipeline and manual segmentation. Prenatal depressive symptoms were self-reported by mothers at gestational weeks 14, 24 and 34 (Edinburgh Postnatal Depression Scale). Sex differences were probed, and possible pre- and postnatal confounders, such as maternal general anxiety, were controlled for. We observed that elevated depressive symptoms of the early second trimester, after controlling for prenatal maternal general anxiety, were significantly related to smaller right amygdalar volumes in the whole sample. Higher depressive symptoms of the third trimester were associated with significantly smaller right amygdalar volumes in boys compared to girls. Altogether, our data suggest that offspring limbic brain development might be affected by maternal depressive symptoms in early pregnancy, and might also be more vulnerable to depressive symptoms in late pregnancy in boys compared to girls.

Prenatal IL-6 levels and activation of the tryptophan to kynurenine pathway are associated with depressive but not anxiety symptoms across the perinatal and the post-partum period in a low-risk sample

Depression and anxiety symptoms are highly prevalent among women during pregnancy and post-partum. Previous studies suggest that one of the pathophysiological underpinnings could be an enhanced metabolism of tryptophan (Trp) into kynurenine (Kyn) due to increased inflammation. However, the longitudinal changes in the Kyn pathway and the complex interplay with inflammation and stress in women with perinatal depressive or anxiety symptoms are incompletely understood. We examined a cohort of healthy women at 34–36 gestational weeks. One hundred and ten women were assessed for salivary cortisol and 97 participants were also assessed for serum levels of Trp, Kyn and Interleukin 6 (IL-6). Women filled in two screening questionnaires for depressive (Edinburgh Postnatal Depression Scale (EPDS)) and anxiety (State Trait Anxiety Inventory subscale (STAI-S)) symptoms at 34–36 gestational weeks, delivery, 3 and 12 months postpartum. Unexpectedly, lower prenatal Kyn levels were associated with higher depressive symptoms in late pregnancy. Furthermore, prenatal Trp levels and the Kyn/Trp ratio moderate the association between IL-6 levels and depressive symptoms during the perinatal and the post-partum period. We found no interactions between Trp and Kyn biomarkers and cortisol on depressive symptoms. The observed associations were more robustly found for depressive symptoms, whereas weak and non-significant effects were found for the trajectory of anxiety symptoms. Overall, our data support the involvement of the Trp to Kyn pathway and inflammation in the course of depressive but not anxiety symptoms in women from late pregnancy until one-year post-partum, providing new evidence on the mechanisms regulating emotions during pregnancy and after delivery in a low-risk sample.

Depressive Symptoms in Late Pregnancy Disrupt Attentional Processing of Negative-Positive Emotion: An Eye-Movement Study.

This study investigated biases for negative–positive information in component processes of visual attention (initial shift vs. maintenance of gaze) among women in late pregnancy with or without depressive symptoms. Eye movements were recorded while participants viewed a series of picture pairs depicting negative, positive, and neutral scenes. Initial orienting (latency and percentage of first fixation) and gaze duration were computed. Compared with neutral pictures, the group with major depressive symptoms (MDS) were less able to sense the positive emotion-related pictures and were over-responsive to negative emotion-related pictures. The group with suspicious depressive symptoms (SDS) had an attention bias toward both positive and negative emotion-related pictures. The group with no depressive symptoms (NDS) had an attention bias toward positive emotion-related pictures and had an initial attention avoidance tendency for negative emotion-related pictures. The initial gaze direction bias score for negative emotion-related pictures was positively correlated with the severity of depressive symptoms. Therefore, women with a risk of perinatal depression have a significant bias toward negative stimuli. Hypervigilant emotion processing during pregnancy may increase a woman’s susceptibility to depression during late pregnancy. Attention away from negative information or attention toward positive information may provide a way of buffering emotional responses.

Maternal and paternal depressive symptoms and children's emotional problems at the age of 2 and 5 years: a longitudinal study

Maternal and paternal depressive symptoms are related to children's emotional problems, but their combined effect remains unclear. Here, we constructed four parental longitudinal depressive symptom trajectory groups and studied their associations with children's emotional problems at the age of 2 and 5years. We did an assessment of maternal and paternal depressive symptoms (gestational week 32, as well as 3, 8 and 24 months postnatally) and children's emotional problems at ages two (N=939) and five (N=700) in the CHILD-SLEEP cohort. Three separate maternal and paternal depressive symptom trajectories based on latent profile analysis were combined to form four parental depressive symptom trajectory groups. We compared groups with a general linear model, with children's emotional (total, internalizing and externalizing) - problem scores serving as the dependent variables. At both ages, combined parental depressive symptom trajectories were associated with children's emotional problems: effect sizes were medium for total and small for other domains. According to post hoc comparisons, children whose mothers or both parents had persistent depressive symptoms had significantly more total, externalizing and internalizing problems than did children who had neither parent nor only the father showing depressive symptoms. A higher (and persistent) level of maternal depressive symptoms was related to a higher level of these children's emotional problems, a pattern not evident with paternal depressive symptoms. In all analyses, the interaction effect was nonsignificant between parental trajectories and child gender. Findings suggest that an absence of depressive symptoms in their fathers cannot compensate for the adverse effects of maternal depressive symptoms upon their children. Moreover, paternal depressive symptoms alone do not lead to increased risk for emotional problems in these 2- and 5-year-old children. In contrast, even subclinical levels of maternal depressive symptoms in late pregnancy are associated with increased risk for their children's experiencing internalizing and externalizing emotional problems.

Shortening day length: a potential risk factor for perinatal depression.

The aim of this secondary analysis was to determine whether seasonal light exposure, categorized by type of day length, is associated with or predictive of depressive symptoms in late pregnancy and the first 3months postpartum. Women (n = 279) expecting their first child were recruited from prenatal clinics and childbirth education classes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Day lengths were categorized into short, lengthening, long and shortening. Data analysis included linear mixed models and multiple linear regression. When days were shortening (August to first 4days of November) in late third trimester, depressive symptom scores were highest (35%) and continued to be higher at each postpartum assessment compared to other day length categories. Implications for clinical practice include increased vigilance for depressive symptoms, particularly if late pregnancy and birth occurs during the 3months around the Autumn equinox when day length is shortening. Strategies that increase light exposure in late pregnancy and postpartum should also be considered.

Maternal depression attenuates newborn vitamin D concentrations in winter-spring: a prospective population-based study

We aimed to investigate whether the newborns of mothers with maternal depression (MD) had lower vitamin D levels than newborns of non-MD (NMD) mothers and identify the potential mechanism underlying this association. Maternal depressive symptoms in late pregnancy and concentrations of cord blood 25 hydroxyvitamin D (25(OH)D) were measured in 1491 mother-infant pairs. Data on maternal sociodemographic characteristics, health status, lifestyle and birth outcomes were prospectively collected. For infants born in winter-spring, the infants of MD mothers had significantly reduced concentrations of 25(OH) D (adjusted β = −3.51 nmol/L; 95% CI: −6.19, −0.84; P = 0.010) and lower birth weight (3267 ± 470 g vs 3348 ± 598 g, F = 4.64, P = 0.031), compared with the infants of NMD mothers. A significant, inverse linear relationship was noted between maternal depression scores and the concentration of 25(OH)D for infants born in winter-spring (adjusted β = −0.158; 95% CI: −0.259, −0.057). The significant, inverse linear relationship between maternal depression scores and fetomaternal ratios of 25(OH) D was also observed among the infants born in winter-spring (adjusted β = −0.005; 95% CI: −0.008, −0.003). MD appears to significantly attenuate the vitamin D concentrations and birth weight of infants born in winter-spring. A decreased fetomaternal ratio of 25(OH)D might be involved in this biological pathway.

Maternal Lipid‐based Nutrient Supplements (LNS) Did Not Reduce Depressive Symptoms During Pregnancy and Lactation in Rural Bangladesh

BackgroundMaternal depression is a major global burden affecting not only women but also their children. Maternal intake and serum levels of polyunsaturated fatty acids have been inconsistently associated with reduced perinatal depression.ObjectiveWe aimed to determine the effects of lipid‐based nutrient supplement (LNS), containing macro and micronutrients, including essential fatty acids (4.6 g of linoleic acid and 0.6 g of alpha‐linolenic acid), on maternal depressive symptoms at 36 weeks of gestation and 6 months postpartum.MethodsWe conducted a cluster‐randomized effectiveness trial in Bangladesh (the Rang‐Din Nutrition Study), where women received either iron & folic acid (IFA) or LNS during pregnancy and the first three or six months postpartum, respectively. Maternal depressive symptoms were assessed by trained interviewers using a validated Bangla version of the Edinburgh Postnatal Depression Scale (EPDS‐B) at 36 weeks of gestation (n=2937) and 6 months postpartum (n=3510) at local antenatal clinics. Outcomes included the EPDS score (range: 0–30) and prevalence of depressive symptoms, defined as an EPDS score ≥10.ResultsOverall median (interquartile range) EPDS scores were 2 (0–4) and 1(0–3) at 36 weeks of gestation and 6 months postpartum, respectively. Prevalence of reported maternal depressive symptoms was low in this population (2.1% at 36 weeks of gestation and 2.7% at 6 months postpartum). Cluster‐adjusted intention‐to‐treat analyses indicated no significant differences by treatment group in EPDS scores (square root back transformed Means ± SEs; 36 weeks of gestation: 1.4 ± 0.1 vs 1.5 ± 0.1 in the LNS and IFA groups, respectively, p=0.22; 6 months postpartum: 1.2 ± 0.1 vs 1.3 ± 0.1 in the LNS and IFA groups, respectively, p=0.12) or prevalence of depressive symptoms (36 weeks of gestation: 2.5% in the LNS and 2.0% in the IFA group, p=0.42; 6 months postpartum: 2.8% in the LNS and 2.6% in the IFA group, p=0.68). Per‐protocol analysis including only those who consumed the supplements regularly indicated lower EPDS scores in the LNS compared to the IFA group at 36 weeks of gestation (1.2 ± 0.1 vs 1.5 ± 0.1, respectively, p=0.01). No other significant differences by treatment group were observed in per‐protocol results.ConclusionIn Bangladesh, maternal LNS did not show an effect on reported depressive symptoms in late pregnancy and at 6 months postpartum. Reports of depressive symptoms in this population were less common than in other populations in Bangladesh, which may have limited our ability to detect effects of LNS.Support or Funding InformationU.S. Agency for International Development (USAID)'s Food and Nutrition Technical Assistance (FANTA) III Project, managed by FHI 360.

Alterations in biological rhythms but not sleep quality predict severity of depressive symptoms in late pregnancy

Alterations in biological rhythms but not sleep quality predict severity of depressive symptoms in late pregnancy

Examining the Factors that Moderate and Mediate the Effects on Depression during Pregnancy and Postpartum

Background: This research report will address the knowledge gap in understanding the role of risk factors as moderators or mediators to explain the variability in the magnitude of exposure and the causal pathway for antenatal and postpartum depression. Methods: Using Feelings in Pregnancy and Motherhood (FIP) longitudinal study, 649 pregnant women were interviewed three times during pregnancy and postpartum. Depression status (measured in EPDS) in late pregnancy and postpartum were two outcomes of interest. Socio-demographic predictors were considered as moderators, and behavioral and psychosocial variables were considered as mediators. Moderators and mediators were tested through series of regression analysis. Results: In modeling moderating effects in late pregnancy, low income women who were in poor partner relationships (β=1.54; p<0.05) and partnered women who reported having used recreational drugs (β= -1.62; p<0.05) were more likely to be depressed. Young mothers with low social support (β= 1.04; p=0.15) and Aboriginal mothers with low social support (β= 1.12; p=0.17) were noted to have depressive symptoms in late pregnancy. In mediating analysis for late pregnancy, psychosocial mediators - stress, social support, and relationship satisfaction, and behavioral factors - smoking and recreational drug use exerted mediating effect for depressive symptoms. In moderating analysis for postpartum, Aboriginal women who had never exercised in late pregnancy were found to be depressed at postpartum. For mediating effects in postpartum, relationship satisfaction, stress, and smoking were significant. Conclusion: The moderating and mediating role of the risk factors could be strategically used to provide tailored programs to women who experience depression during pregnancy and postpartum.

Maternal depressive symptoms related to Epstein-Barr virus reactivation in late pregnancy

We examined the relationship between maternal depressive symptoms in late pregnancy and Epstein-Barr virus reactivation before delivery. In this prospective observational study, prevalence of Epstein-Barr virus reactivation within one week before delivery was compared between 163 pregnant women with depressive symptoms at 33 to 34 weeks of gestation and a computer-generated control group of 163 pregnant healthy women without depressive symptoms. Depressive symptoms at 33 to 34 weeks of gestation were significantly related to the prevalence of Epstein-Barr virus reactivation before delivery after adjustment for potential confounders (adjusted OR = 2.74, 95%CI: 1.23–6.08). Compared to that in the control group, the prevalence of Epstein-Barr virus reactivation was higher in women with depressive symptoms accompanied by higher negative coping (24.2% compared with 7.9%; adjusted OR = 3.67, 95%CI: 1.47–9.16). Maternal depressive symptoms in late pregnancy are associated with Epstein-Barr virus reactivation, and this association could be moderated by maternal coping style.

P.2.a.008 Low serum allopregnanolone is associated with elevated depressive symptoms in late pregnancy

Universal screening for postpartum depression is crucial for early detection, interventions and support. The aim of this study was to describe the proportion of, and explore risk factors for, women not being offered screening, as well as for declining an offer or not being screened due to any other unknown reason.Socioeconomic, obstetrical and neonatal data, extracted from the Swedish Pregnancy Registry, for 9,959 pregnancies recorded for the Östergötland county between 2016 and 2018 were linked to Edinburgh Postnatal Depression Scale (EPDS) screening results at 6–8 weeks postpartum, extracted from medical records. Risk factors were assessed using logistic regression models and with a nomogram for easy visualization.In total, there were no recorded offers of EPDS screening in the medical records for 30.0% of women at the postpartum follow-up. Women born outside of Sweden and women reporting poor self-rated health were at increased risk of not being offered screening for postpartum depression.There is a possibility that women were offered screening or were screened, but this was incorrectly or never recorded in medical records.The majority of women were offered screening for postpartum depression, but there is room for improvement in order to achieve universal screening. Awareness among healthcare providers of the risk factors for not screening might increase adherence to guidelines for universal screening. Overcoming barriers for screening and raising the topic of mental-health issues for postpartum women should be prioritized.

Insomnia and Depressive Symptoms in Late Pregnancy: A Population-Based Study

A population-based questionnaire study of 2,816 women was conducted in week 32 of pregnancy to estimate the prevalence of and risk factors for insomnia and depressive symptoms. The Bergen Insomnia Scale (BIS) measured insomnia. The Edinburgh Postnatal Depression Scale (EPDS) measured depressive symptoms. The prevalence of insomnia (DSM-IV-TR criteria) was 61.9%, and mean BIS score 17.5 (SD = 10.5), significantly higher than among the general population. The prevalence of depressive symptoms (EPDS ≥ 10) was 14.6%. Depressive symptoms were strongly associated with insomnia during late pregnancy, especially with sleep durations <5 or >10 hours, sleep efficiency <75%, daytime impairment, and long sleep onset latency. Pelvic girdle pain and lower back pain was associated with insomnia, but not with depressive symptoms.

How Much Does Low Socioeconomic Status Increase the Risk of Prenatal and Postpartum Depressive Symptoms in First-Time Mothers?

To examine socioeconomic status (SES) as a risk factor for depressive symptoms in late pregnancy and the early postpartum period. A secondary objective was to determine whether SES was a specific risk factor for elevated postpartum depressive symptoms beyond its contribution to prenatal depressive symptoms. Quantitative, secondary analysis, repeated measures, descriptive design. Participants were recruited from paid childbirth classes serving upper middle class women and Medicaid-funded hospitals serving low-income clients in Northern California. A sample of 198 first-time mothers was assessed for depressive symptoms in their third trimester of pregnancy and at 1, 2, and 3 months postpartum. Depressive symptoms were measured with the Center for Epidemiological Studies-Depression (CES-D) Scale. Low SES was associated with increased depressive symptoms in late pregnancy and at 2 and 3 months, but not at 1 month postpartum. Women with four SES risk factors (low monthly income, less than a college education, unmarried, unemployed) were 11 times more likely than women with no SES risk factors to have clinically elevated depression scores at 3 months postpartum, even after controlling for the level of prenatal depressive symptoms. Although new mothers from all SES strata are at risk for postpartum depression, SES factors including low education, low income, being unmarried, and being unemployed increased the risk of developing postpartum depressive symptoms in this sample.

CYP2D6 genotypes and depressive symptoms during late pregnancy and postpartum

The aim of this exploratory was to investigate the theory of a relation between cytochrome P450 2D6 (CYP2D6) genotype and depressive symptoms in late pregnancy and/or postpartum. We studied 145 women with depressive symptoms. CYP2D6 genotype was analysed in leukocyte DNA by polymerase chain reaction (PCR). There were no significant differences in CYP2D6 genotypes between the groups of women being depressed during and/or after pregnancy. The frequencies of CYP2D6 genotypes did not differ from other European studies. This study cannot confirm that depressive symptoms in late pregnancy and postpartum are connected with CYP2D6 genotype. It is, however, noteworthy that the frequency of ultrarapid metabolizers was higher than in a general Caucasian population. This warrants further exploration in a greater study sample, but should also be investigated in a general population with major depression.

Prevalence of depressive symptoms in late pregnancy and postpartum.

Postnatal depression refers to a non-psychotic depressive episode that begins in or extends into the postpartum period. The aims of this study were to examine the prevalence of depressive symptoms in a pregnant and later postnatal population, to determine the natural course of these symptoms and whether there is an association between antenatal and postnatal depressive symptomatology. A longitudinal study with a total population of 1,558 consecutively registered pregnant women in the southeast region of Sweden. Presence of depressive symptoms was measured with the Edinburgh Postnatal Depression Scale on four occasions namely in gestational week 35-36, in the maternity ward, 6-8 weeks and 6 months postpartum. The prevalence of depressive symptoms during late pregnancy was 17%; in the maternity ward 18%; 6-8 weeks postnatally 13%; and 6 months postnatally, 13%. A correlation between antenatal and postnatal depressive symptoms was found (r=0.50, p<0.0001). Detection of women at risk for developing postnatal depressive symptoms can be done during late pregnancy. Antenatal care clinics constitute a natural and useful environment for recognition of women with depressive symptoms.

Prevalence of depressive symptoms in late pregnancy and postpartum

Background. Postnatal depression refers to a non-psychotic depressive episode that begins in or extends into the postpartum period. The aims of this study were to examine the prevalence of depressive symptoms in a pregnant and later postnatal population, to determine the natural course of these symptoms and whether there is an association between antenatal and postnatal depressive symptomatology. Methods. A longitudinal study with a total population of 1,558 consecutively registered pregnant women in the southeast region of Sweden. Presence of depressive symptoms was measured with the Edinburgh Postnatal Depression Scale on four occasions namely in gestational week 35–36, in the maternity ward, 6–8 weeks and 6 months postpartum. Results. The prevalence of depressive symptoms during late pregnancy was 17%; in the maternity ward 18%; 6–8 weeks postnatally 13%; and 6 months postnatally, 13%. A correlation between antenatal and postnatal depressive symptoms was found (r=0.50, p<0.0001). Conclusion. Detection of women at risk for developing postnatal depressive symptoms can be done during late pregnancy. Antenatal care clinics constitute a natural and useful environment for recognition of women with depressive symptoms.