Patterns of pregnancy and postpartum depressive symptoms: Latent class trajectories and predictors.

Abstract

Depressive symptoms among pregnant and postpartum women are common. However, recent studies indicate that depressive symptoms in the perinatal period do not follow a uniform course, and investigations of the heterogeneity of time courses and associated factors are needed. The aim of this study was to explore whether depressive symptoms in the perinatal period could be categorized into several distinct trajectories of symptom development among subgroups of perinatal women, and to identify predictors of these trajectory groups. The study used data from 1,036 Norwegian women participating in a community-based prospective study from midpregnancy until 12-months postpartum. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale at 7 time points (4 during pregnancy). Partner-related attachment, stress, childhood adversities, pregnancy-related anxiety, previous psychopathology, and socioeconomic conditions were assessed at enrollment. By means of growth mixture modeling based on piecewise growth curves, 4 classes of depressive symptom trajectories were identified, including (a) pregnancy only (4.4%); (b) postpartum only (2.2%); (c) moderate-persistent (10.5%); and (d) minimum symptoms (82.9%) classes. Multinomial logistic regression analyses showed that membership in the pregnancy only and postpartum only classes primarily was associated with pregnancy-related anxiety and previous psychopathology, respectively, whereas the moderate-persistent class was associated with diverse psychosocial adversity factors. Findings suggest heterogeneity in temporal patterns of elevated depressive mood, relating specific trajectories of time courses with distinct adversity factors. Researchers and clinicians should be aware of possible multiple courses of elevated perinatal depressive mood, and inquire about possible diverse adversity factors, aberrant pathways, and prognoses. (PsycINFO Database Record

Repetitive Negative Thinking and Its Role in Perinatal Mental Health

“…As noted above, the primary approach taken in studies in this area to date has been to test the hypothesis that levels of RNT reported in the antenatal period predict poor psychological adjustment in the post-partum period. However, the identification of distinct classes of postnatal depressive symptom trajectories (e.g., depressive symptoms in pregnancy only, post-partum symptoms only, symptoms that persist from pregnancy to the post-partum period [35]), coupled with findings that RNT predicts postnatal depression only in combination with other factors (e.g., perfectionism [28]; social functioning [27]), suggests that a relatively linear account of pre-birth RNT serving as a risk factor for developing postnatal depression and anxiety may not capture the clinical reality for all women who experience post-partum psychological symptoms.…”

Temperamental Adaptability, Persistence, and Regularity: Parental Ratings of Norwegian Infants Aged 6 to 12 Months, With Some Implications for Preventive Practice

“…LiN is an ongoing Norwegian longitudinal project (cf. Skjothaug, Smith, Wentzel‐Larsen, & Moe, ; Fredriksen, von Soest, Smith & Moe, ). The study is community‐based with a prospective cohort design, investigating pre‐ and postnatal risk and promotive factors influencing early child development and mental health.…”

“…Attrition analysis for the mothers in the LiN study is reported in Fredriksen et al. (). Briefly, 50.7% of the mothers consented at the four well‐baby clinics where this was reliably recorded.…”

Effect of Acupressure, Acupuncture and Moxibustion in Women With Pregnancy-Related Anxiety and Previous Depression: A Preliminary Study

“…Both pregnancy-related anxiety and previous psychopathology have been observed to be associated with the occurrence of depressive symptoms among pregnant and postpartum women [1, 2]; however, some kinds of intervention have been reported to reduce the relapse/deterioration of depressive symptom during pregnancy and postpartum [3, 4]. Recently, some oriental treatments such as acupressure (Shiatsu), acupuncture and moxibustion have seemed to be an effective optional treatment in patients with depression [5-9].…”