Depression, stress, and anxiety, termed ‘psychological distress,’ are common in pregnancy and postpartum periods. However, it is unclear whether prenatal psychological distress predicts postpartum psychological distress. We studied the prevalence, comorbidity and associations of maternal depression, stress, and anxiety in the prenatal period in relation to the occurrence of these same measures in the postpartum period.
Data originated from the MotherToBaby study of pregnant women residing in the U.S or Canada (2016–2018). Risk ratios and 95% Confidence Intervals using modified-Poisson regression models were used to investigate associations between prenatal psychological distress and postpartum psychological distress.
Of the 288 women in the analysis, 21.2% and 26.7% of women had evidence of prenatal and postnatal psychological distress, respectively. Among those with prenatal psychological distress, 43 (70.5%) also had postpartum psychological distress. Twenty-five (41%) of those with prenatal and 46 (60%) of those with postpartum psychological distress had comorbidity of at least two of the measures. Prenatal measures independently predicted the same postnatal measures; prenatal anxiety also independently predicted postpartum stress. Participants who experienced more types of prenatal psychological distress were at higher risk for postpartum depression, stress, and anxiety.
Depression, stress, and anxiety are common in pregnant women and often occur together. Prenatal psychological distress measures are associated with postnatal psychological distress measures, with stronger associations among women with more than one type of psychological distress in pregnancy. Interventions during pregnancy may reduce the risk of postpartum psychological distress.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Women and Birth
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Sex differences in anxiety and depression clinical perspectives.Front. Neuroendocrinol. 2014; 35: 320-330
- Public Health Context of Women’s Mental Health Research — Abstract.Europe PMC, 2003
- Identifying the women at risk of antenatal anxiety and depression: a systematic review.J. Affect. Disord. 2016; : 62-77
- Perinatal depression and birth outcomes in a healthy start project.Matern. Child Health J. 2011; 15: 401-409
- Anxiety and fear of childbirth as predictors of postnatal depression in nulliparous women.Women Birth. 2012; 25: e37-43
- Postpartum depression.Am. J. Obstet. Gynecol. 2009; 200: 357-364
- Depression and anxiety during the perinatal period.BMC Psychiatry. 2015; 15: 206
- Depression during pregnancy: a risk factor for adverse neonatal outcomes? A critical review of the literature.J. Matern. Fetal. Neonatal. Med. 2014; 27: 960-967
- Psychosocial stress during pregnancy and perinatal outcomes: a meta-analytic review.J. Psychosom. Obstet. Gynaecol. 2010; 31: 219-228
- Prenatal stress and neurodevelopment of the child: focus on the HPA axis and role of the placenta.Dev. Neurosci. 2009; 31: 285-292
- Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review.Neurosci. Biobehav. Rev. 2005; 29: 237-258
- Antenatal maternal stress and long-term effects on child neurodevelopment: how and why?.J. Child Psychol. Psychiatry. 2007; 48: 245-261
- Annual Research Review: prenatal stress and the origins of psychopathology: an evolutionary perspective.J. Child Psychol. Psychiatry. 2011; 52: 356-367
- The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R).JAMA. 2003; 289: 3095-3105
- Psychosocial features associated with lifetime comorbidity of major depression and anxiety disorders among a community sample of mid-life women: the SWAN mental health study.Depress. Anxiety. 2012; 29: 1050-1057
- Risk factors for depressive symptoms during pregnancy: a systematic review.Am. J. Obstet. Gynecol. 2010; 202: 5-14
- Risk factors for antenatal depression, postnatal depression and parenting stress.BMC Psychiatry. 2008; 8: 1-11
- Rates and risk of postpartum depression—a meta-analysis.Int. Rev. Psychiatry. 2009; 8: 37-54
- A meta-analysis of predictors of postpartum depression.Nurs. Res. 2019; 45: 297-303
- Predictors of postpartum depression: an update.Nurs. Res. 2001; 50: 275-285
- Postmarketing surveillance for human teratogenicity: a model approach.Teratology. 2001; 64: 252-261
- Risks and safety of pandemic H1N1 influenza vaccine in pregnancy: birth defects, spontaneous abortion, preterm delivery, and small for gestational age infants.Vaccine. 2013; 31: 5026-5032
- Birth outcomes in pregnant women taking fluoxetine.N. Engl. J. Med. 1996; 335: 1010-1015
- Detection of postnatal depression. Development of the 10-item edinburgh postnatal depression scale.Br. J. Psychiatry. 1987; 150: 782-786
- Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale: implications for clinical and research practice.Arch. Womens Ment. Health. 2006; 9: 309-315
- A global measure of perceived stress.J. Health Soc. Behav. 1983; 24: 385-396
Stress Beefs Up the Waistline — How Stressed Are You? | UCTV Blog, 2018.
- Manual for the State-Trait Anxiety Inventory.1970
- Examining the relationship between antenatal anxiety and postnatal depression.J. Affect Disord. 2007; 101: 169-174
- 2000 CDC Growth Charts for the United States.2019
- Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 42 weeks.Pediatrics. 1966; 37: 403-408
- Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice.2019
Gavin NI ea: Perinatal depression: a systematic review of prevalence and incidence. - PubMed - NCBI. 2019.
- Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety.J. Affect. Disord. 2016; 198: 142-147
- Predictors of postpartum stress.J. Clin. Nurs. 2011; 20: 666-674
- Implementing the USPSTF recommendations on prevention of perinatal depression—opportunities and challenges.JAMA Intern. Med. 2019; 179: 467-468
- Interventions to prevent perinatal depression: evidence report and systematic review for the US preventive services task force.JAMA. 2019; 321: 588-601
- Psychosocial risk factors for depression during pregnancy.Acta Obstet. Gynecol. Scand. 2009; 88: 599-605
- Prevalence, course, and risk factors for antenatal anxiety and depression.Obstet. Gynecol. 2007; 110: 1102-1112
- Major and minor depression in pregnancy.Obstet. Gynecol. 2009; 113: 1292-1298
- Antenatal depression: prevalence and risk factors in a hospital based Turkish sample.J. Pak. Med. Assoc. 2013; 63: 472-477
- Depression during pregnancy: rates, risks and consequences—motherisk update 2008.Can. J. Clin. Pharmacol. 2009; 16: e15-e22
- Stress as a trigger of autoimmune disease.Autoimmun. Rev. 2008; 7: 209-213
- Stress and rheumatic diseases.Rheum. Dis. Clin. North Am. 2000; 26 (viii): 737-763
P.T. Huerta, C. Kowal, L.A. DeGiorgio, et al. Immunity and behavior: Antibodies alter emotion. 2006.
- Rheumatoid arthritis and depression: an inflammatory perspective.Lancet Psychiatry. 2019; 6: 164-173
Published online: February 05, 2020
Accepted: January 19, 2020
Received in revised form: December 16, 2019
Received: September 6, 2019
© 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.