Patterns of maternal depression, anxiety, and stress symptoms from pregnancy to 5 years postpartum in an Australian cohort experiencing adversity

Bryson, Hannah; Perlen, Susan; Price, Anna; Mensah, Fiona; Gold, Lisa; Dakin, Penelope; Goldfeld, Sharon

doi:10.1007/s00737-021-01145-0

Cited by 26 publications

(24 citation statements)

References 35 publications

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“…Moreover, 23 women (9.1%) did not provide any reason. Globally, our retention rate is comparable with those reported by other studies adopting a similar methodology ( 22 , 37 ).…”

Section: Resultssupporting

confidence: 91%

The Transition From Maternity Blues to Full-Blown Perinatal Depression: Results From a Longitudinal Study

et al. 2021

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Background: The aims of the present study are to: (1) assess the frequency of maternity blues (MB); (2) identify the clinical and social characteristics more frequently associated with the onset of depressive symptoms after delivery; and (3) verify the hypothesis that the presence of maternity blues is a risk factor for the onset of a full-blown depressive episode in the 12 months after delivery.Methods: This is a longitudinal observational study. All pregnant women who gave birth at the inpatient unit of Gynecology and Obstetrics of the University of Campania “Luigi Vanvitelli” from December 2019 to February 2021 have been invited to participate in the study. Upon acceptance, women were asked to complete the Italian version of the Edinburgh Postnatal Depression Scale along with an ad-hoc questionnaire on the women's sociodemographic, gynecological and peripartum characteristics as well as their psychiatric history. Women have been reassessed after one, 3, 6 and 12 months.Results: A total of 359 women were recruited within 3 days from delivery, with a mean EPDS total score of 5.51 (±4.20). Eighty-three women (23.1%) reported the presence of maternity blues. Mean EPDS total scores were 12.8 (±0.2) in the MB group vs. 4.26 (±0.2) in the group without MB (p <0.0001). MB predictors were the presence of an anxiety disorder with an onset 6 months prior to pregnancy, of preeclampsia, of increased fetal health rate, of conflicts with relatives other than partner and having a partner with an anxiety disorder. At multivariate analyses the presence of MB increased 7-time the risk to have a higher EPDS score at follow-up assessments (OR: 7.79; CI: 6.88–8.70, p <0.000). This risk is almost four times higher 1 months after the delivery (OR: 4.66; CI: 2.54–6.75, p < 0.000), almost three times higher after 3 months (OR: 2.98; CI: 0.50–5.46, p < 0.01) and almost six times higher after 12 months (OR: 5.88; CI: 3.20–8.54, p < 0.000).Conclusions: Although MB was a self-limiting condition in the majority of cases, depressive symptoms arose quite often immediately after the childbirth. Professionals should be trained to monitor symptoms of MB and its transition toward a depressive episode.

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“…Moreover, 23 women (9.1%) did not provide any reason. Globally, our retention rate is comparable with those reported by other studies adopting a similar methodology ( 22 , 37 ).…”

Section: Resultssupporting

confidence: 91%

The Transition From Maternity Blues to Full-Blown Perinatal Depression: Results From a Longitudinal Study

et al. 2021

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“…We also found evidence that past mental health (i.e., the pre-pregnancy and pregnancy periods) is associated with postpartum mental health. This result is consistent with longitudinal studies that reported women experiencing depressive symptoms during pregnancy are at high risk of postpartum depression [ 27 , 60 , 61 ].…”

Section: Discussionsupporting

confidence: 92%

Perceived social support on postpartum mental health: An instrumental variable analysis

Inekwe

Lee

2022

PLoS ONE

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The postpartum period is a challenging transition period with almost one in ten mothers experiencing depression after childbirth. Perceived social support is associated with mental health. Yet empirical evidence regarding the causal effects of social support on postpartum mental health remains scarce. In this paper, we used a nationally representative panel data of women to examine causality between perceived social support and postpartum mental health. We used fixed-effect method and included dependent variable lags to account for past mental health condition before birth (i.e., the pre-pregnancy and prenatal periods). The study also used an instrumental variable approach to address endogeneity. We find a declining trend in postpartum mental health between 2002 to 2018. Our study also showed that past mental health (i.e., before childbirth) is positively correlated with postpartum mental health. A universal routine mental health screening for expectant and new mothers should remain a key priority to ensure mental wellbeing for the mothers and their infants.

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“…Our findings extend on the existing literature by demonstrating the relationship for Australian families experiencing adversity. Notably, families in the current cohort were already less likely to be in paid employment (53%) or have poorer mental health (20–30% with high mental health symptoms, see Bryson et al [ 43 ]) before the pandemic. As such, the relative impacts of the public health restrictions are arguably greater for these families and likely to exacerbate existing health disparities.…”

Section: Discussionmentioning

confidence: 91%

Clinical, financial and social impacts of COVID-19 and their associations with mental health for mothers and children experiencing adversity in Australia

et al. 2021

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Background Australia has maintained low rates of SARS-COV-2 (COVID-19) infection, due to geographic location and strict public health restrictions. However, the financial and social impacts of these restrictions can negatively affect parents’ and children’s mental health. In an existing cohort of mothers recruited for their experience of adversity, this study examined: 1) families’ experiences of the COVID-19 pandemic and public health restrictions in terms of clinical exposure, financial hardship family stress, and family resilience (termed ‘COVID-19 impacts’); and 2) associations between COVID-19 impacts and maternal and child mental health. Methods Participants were mothers recruited during pregnancy (2013–14) across two Australian states (Victoria and Tasmania) for the ‘right@home’ trial. A COVID-19 survey was conducted from May-December 2020, when children were 5.9–7.2 years old. Mothers reported COVID-19 impacts, their own mental health (Depression, Anxiety, Stress Scales short-form) and their child’s mental health (CoRonavIruS Health and Impact Survey subscale). Associations between COVID-19 impacts and mental health were examined using regression models controlling for pre-COVID-19 characteristics. Results 319/406 (79%) mothers completed the COVID-19 survey. Only one reported having had COVID-19. Rates of self-quarantine (20%), job or income loss (27%) and family stress (e.g., difficulty managing children’s at-home learning (40%)) were high. Many mothers also reported family resilience (e.g., family found good ways of coping (49%)). COVID-19 impacts associated with poorer mental health (standardised coefficients) included self-quarantine (mother: β = 0.46, child: β = 0.46), financial hardship (mother: β = 0.27, child: β = 0.37) and family stress (mother: β = 0.49, child: β = 0.74). Family resilience was associated with better mental health (mother: β = -0.40, child: β = -0.46). Conclusions The financial and social impacts of Australia’s public health restrictions have substantially affected families experiencing adversity, and their mental health. These impacts are likely to exacerbate inequities arising from adversity. To recover from COVID-19, policy investment should include income support and universal access to family health services.

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Patterns of maternal depression, anxiety, and stress symptoms from pregnancy to 5 years postpartum in an Australian cohort experiencing adversity

Cited by 26 publications

References 35 publications

The Transition From Maternity Blues to Full-Blown Perinatal Depression: Results From a Longitudinal Study

The Transition From Maternity Blues to Full-Blown Perinatal Depression: Results From a Longitudinal Study

Perceived social support on postpartum mental health: An instrumental variable analysis

Clinical, financial and social impacts of COVID-19 and their associations with mental health for mothers and children experiencing adversity in Australia

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