Association between parental depressive symptoms and impaired bonding with the infant

Impaired bonding with the infant is associated with maternal postpartum depression but has not been investigated extensively in fathers. The primary study aim was to evaluate associations between maternal and paternal depressive symptoms and impaired bonding with their infant. A secondary aim was to determine the associations between parents’ marital problems and impaired bonding with the infant. The study is part of a population-based cohort project (UPPSAT) in Uppsala, Sweden. The Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks and 6 months postpartum and the Postpartum Bonding Questionnaire at 6 months postpartum were completed by 727 couples. The prevalence of impaired bonding was highest among couples in which both spouses had depressive symptoms. Impaired bonding was associated with higher EPDS scores in both mothers and fathers, as well as with experiencing a deteriorated marital relationship. The association between maternal and paternal impaired bonding and the mothers’ and fathers’ EPDS scores remained significant even after adjustment for relevant confounding factors. Depressive symptoms at 6 weeks postpartum are associated with impaired bonding with the infant at 6 months postpartum for both mothers and fathers. It is critical to screen for and prevent depressive symptoms in both parents during early parenthood.     

Does breastfeeding offer protection against maternal depressive symptomatology?

Mothers who breastfeed typically exhibit lower levels of depressive symptomatology than mothers who do not. However, very few studies have investigated the directionality of this relationship. Of the prospective studies published, all but one focus exclusively on whether maternal depression reduces rates of subsequent breastfeeding. This study again examines this relationship, but also the reverse—that breastfeeding might predict lower levels of later depression. Using multilevel modeling, we investigated the relationship between breastfeeding and self-reported depressive symptomatology in 205 women followed prenatally and at 3, 6, 12, and 24 months after birth. Consistent with previous research, women with prenatal depressive symptomatology weaned their infants 2.3 months earlier, on average, than women without such symptomatology. We also found, however, that women who breastfed more frequently at 3 months postpartum showed greater subsequent declines in depressive symptomatology over time compared to women who breastfed less frequently, resulting in lower absolute levels of depressive symptoms by 24 months postpartum, controlling for important confounds. In sum, these findings are consistent with a bidirectional association between breastfeeding and depression, with prenatal depression predicting less breastfeeding soon after birth and breastfeeding predicting declines in maternal depression up to 2 years after birth. We discuss mechanisms that could potentially explain these associations and avenues for future research.     

Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum

To determine the contribution of infant temperament to the relationship between maternal sleep disturbance and depressive symptoms. Utilizing a repeated measures design, 112 couples recruited from childbirth education classes were assessed in third trimester and postpartum. Instruments included Center for Epidemiologic Studies Depression Scale, General Sleep Disturbance Scale, wrist actigraphy, and an investigator-developed tool to assess infant temperament completed by mothers and fathers. Regardless of infant temperament, mothers who slept < 4 h between midnight and 6 am and mothers who napped < 60 min during the day were at increased risk for depression at three months postpartum. Infant temperament was associated with maternal sleep but was not a significant predictor of depressive symptoms after controlling for other contextual factors. Postpartum clinical visits should include questions about maternal sleep so interventions can be directed toward sufficient sleep to minimize risk of postpartum depression.     

Maternal anxiety disorders prior to conception, psychopathology during pregnancy and early infants’ development: a prospective-longitudinal study

Family-genetic studies suggest that anxiety disorders run in families and that mechanisms of familial transmission might act as early as during pregnancy. The aims of the Maternal Anxiety in Relation to Infant Development (MARI) Study are to prospectively investigate the course of pregnancy in women with and without anxiety disorders prior to conception from early pregnancy to postpartum focussing on (a) maternal psychopathology, (b) maternal perinatal health, and (c) offspring outcomes that are supposed to be early indicators/ antecendents for later anxiety disorders. The MARI Study is a prospective-longitudinal study program with seven waves of assessment: T1 (baseline: week 10 to 12 of gestation), T2 (week 22 to 24 of gestation), T3 (week 35 to 37 of gestation), T4 (10 days postpartum), T5 (2 months postpartum), T6 (4 months postpartum), and T7 (16 months postpartum). Overall, N?=?306 pregnant women were enrolled during early pregnancy (T1) and allocated to one of the following initial diagnostic groups: no AD: no anxiety nor depressive disorder prior to pregnancy (N?=?109), pure D: pure depressive disorder(s) prior to pregnancy (N?=?48), pure A: pure anxiety disorder(s) prior to pregnancy (N?=?84), and comorbid AD: comorbid anxiety and depressive disorders prior to pregnancy (N?=?65). Overall, N?=?284 mothers could be retained until T6 (retention rate: 92.8 %) and N?=?274 until T7 (retention rate: 89.5 %). Clinical and psychosocial measures were used including a standardized diagnostic interview (CIDI-V) with dimensional scales and standardized observation paradigms (mother-infant-relationship, infant temperament and neuropsychological development). Dimensional anxiety and depression liability indices were developed to reflect the severity of anxiety and depressive disorders prior to pregnancy and to ease longitudinal modelling. Findings from this study will contribute to improved knowledge about the natural course of anxiety disorders during transition to parenthood and associated outcomes that are assumed to be early indicators of later psychopathology in the offspring. Results are expected to provide new insights into mechanisms of familial transmission and clues for targeted prevention and early intervention.     

Stability and change in level of maternal depressive symptomatology during the first postpartum year

BACKGROUND: This study evaluated stability and change in the level of maternal depressive symptomatology over the course of the first postpartum year in a community cohort of 106 first-time mothers of full-term, healthy infants. Effects of diagnosed depression and infant gender were also assessed. METHODS: At 2 months postpartum (intake), mothers were classified into one of two symptom groups on the basis of their total score on the Center for Epidemiological Studies-Depression Scale (CES-D): high (CES-D score > or = 16, 46%) or normative (CES-D score = 2-12, 54%). Mothers completed the CES-D again at 3, 6, and 12 months postpartum. At 12 months, maternal diagnostic status for major depression and related disorders was evaluated using the Diagnostic Interview Schedule-III-Revised. RESULTS: Mothers in the High symptom group at intake continued to have significantly higher CES-D scores at 3, 6, and 12 months than mothers in the Normative symptom group at intake, and a third in the High symptom group at intake had a subsequent CES-D score above the clinical cutoff (> or = 16). Maternal CES-D scores were significantly correlated across visits. In regressions controlling for diagnostic status and infant gender, mothers' CES-D score at the most recent prior assessment contributed significant unique variance to mothers' CES-D score at each subsequent assessment. CES-D scores were higher at 3 months if mothers had diagnosed depression and were parenting a son, and higher at 12 months if mothers had both diagnosed depression and a prior, high CES-D score. LIMITATIONS: Findings may not generalize to multipara or high-risk cohorts. CONCLUSIONS: First-time mothers with high levels of depressive symptomatology at 2 months postpartum (especially those with diagnosed depression) are at increased risk of continuing to experience high levels of depressive symptomatology throughout the first postpartum year. Implications for preventative intervention services are discussed.     

Trajectories of maternal depressive symptoms across the birth of a child: associations with toddler emotional development

Depression during the perinatal period is common and impacts the physical and psychological well-being of those who experience it. One area of particular significance is the course of maternal depression across time, including the differential effects of depression trajectories during the perinatal period on early child development. The current study explored trajectories of maternal depressive symptoms from pregnancy through 2 years postpartum and their relation to toddler emotional development. Participants included 120 primarily low-income, ethnically diverse women and their toddlers. Depression was assessed during pregnancy, at 3 months postpartum, and at 1 and 2 years postpartum. Toddler emotional development was assessed at age 2 via video observations and mother report. Results indicated a four-class model that best fits the data: low-decreasing (47.5 %), stable-low (22.5 %), stable-moderate (21.7 %), and increasing (8.3 %) trajectories of maternal depressive symptoms. Women in the increasing group reported significantly more toddler social and emotional problems at age 2 than women in all other groups, and women in the stable-moderate group reported significantly more toddler social and emotional problems at age 2 than women in the stable-low group. No associations between trajectories and observed toddler affect expression were found. Results highlight variable courses of depressive symptoms for women across the birth of a child as well as the importance of reducing depression for the benefit of both mother and child. It is important for clinicians working with pregnant and postpartum mothers to assess for depressive symptoms over time and not just at a single time point.     

Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms

During the postpartum period, women are at higher risk of developing a mental disorder such as postpartum depression (PPD), a disorder that associates with mother–infant bonding and child development. Oxytocin is considered to play a key role in mother–infant bonding and social interactions and altered oxytocin plasma concentrations were found to be associated with PPD. In the present study, we evaluated oxytocin plasma levels and depressive symptoms during pregnancy and the postpartum period in healthy women. We evaluated 100 women twice during pregnancy (weeks 35 and 38) and three times in the postpartum period (within 2 days and 7 weeks and 6 months after delivery) by measuring oxytocin plasma levels with enzyme-linked immunosorbent assay (ELISA) and assessing depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Oxytocin plasma levels significantly increased from the 35th week of gestation to 6 months postpartum in all women. However, levels decreased from the 38th week of gestation to 2 days after delivery in participants with postpartum depressive symptoms, whereas they continuously increased in the group without postpartum depressive symptoms; the difference between the course of oxytocin levels in the two groups was significant (Δt2–t3: t?=?2.14; p?=?0.036*). Previous depressive episodes and breastfeeding problems predicted postpartum depressive symptoms. Our results indicate that alterations in the oxytocin system during pregnancy might be specific for women who develop postpartum depressive symptoms. Future studies should investigate whether oxytocin plasma levels might have predictive value in women at high risk for PPD.     

Maternal depression from pregnancy to 4 years postpartum and emotional/behavioural difficulties in children: results from a prospective pregnancy cohort study

Considerable attention has been focused on women’s mental health in the perinatal period and the subsequent impacts on children. Comparatively, we know much less about maternal depression at later time points and the potential implications for child mental health. The objective of this paper was to explore the association between maternal depression and child emotional/behavioural difficulties at 4 years postpartum, taking into account earlier episodes of perinatal depression. The Maternal Health Study is a prospective cohort study of 1,507 nulliparous women. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy and at 3, 6 and 12 months postpartum and again at 4 years postpartum. Maternal depressive symptoms at 4 years postpartum were associated with significantly increased odds of child emotional/behavioural difficulties (odds ratio (OR)?=?3.46, 95 % confidence interval (CI)?=?2.21–5.43). This remained significant after adjusting for earlier episodes of perinatal depression and socio-demographic characteristics (OR?=?2.07, 95 % CI?=?1.18–3.63). We also observed a robust association between child difficulties at age 4 and measures of socio-economic disadvantage. Our findings suggest a pressing need to rethink current paradigms of maternal health surveillance and extend mental health surveillance and support to at least 4 years postpartum.     

Prevalence of paternal perinatal depressiveness and its link to partnership satisfaction and birth concerns

Depressive disorders have shown an increasing prevalence over the past decades. Growing evidence suggests that pregnancy and childbirth trigger depressive symptoms not only in women but likewise in men. This study estimates the prevalence of paternal perinatal depressiveness in a German community sample and explores its link to partnership satisfaction as well as birth-related concerns and concerns about the future. Data was gathered in a longitudinal study over the second and third trimester of their partner’s pregnancy up to 6 weeks postpartum. In a two-stage screening procedure, 102 expectant fathers were assessed for symptoms of depression, anxiety, and partnership satisfaction using the Edinburgh Postnatal depression Scale (EPDS), the State/Trait Anxiety Inventory, a self-constructed questionnaire for birth concerns and the Questionnaire of Partnership. The prevalence of elevated depressive symptoms among expectant fathers was 9.8 % prenatally and 7.8 % postnatally. Prenatal relationship quality, prenatal EPDS scores, and birth concerns were significantly associated with and explained 47 % of the variance in paternal postnatal depressive symptoms. The prevalence of paternal depressive symptoms is a significant concern. Our findings point out the need for implementing awareness and screening for depressiveness in fathers in clinical routine in Germany as well as the necessity of developing a screening instrument for paternal birth-related anxiety.     

An intervention to reduce postpartum depressive symptoms: a randomized controlled trial

Depressive symptoms and depression are a common complication of childbirth, and a growing body of literature suggests that there are modifiable factors associated with their occurrence. We developed a behavioral educational intervention targeting these factors and successfully reduced postpartum depressive symptoms in a randomized trial among low-income black and Latina women. We now report results of 540 predominantly white, high-income mothers in a second randomized trial. Mothers in the intervention arm received a two-step intervention that prepared and educated mothers about modifiable factors associated with postpartum depressive symptoms (e.g., physical symptoms, low self-efficacy), bolstered social support, and enhanced management skills. The control arm received enhanced usual care. Participants were surveyed prior to randomization, 3 weeks, 3 months, and 6 months postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS of 10 or greater). Prevalence of depressive symptoms postpartum was unexpectedly low precluding detection of difference in rates of depressive symptoms among intervention versus enhanced usual care posthospitalization: 3 weeks (6.0 vs. 5.6 %, p?=?0.83), 3 months (5.1 vs. 6.5 %, p?=?0.53), and 6 months (3.6 vs. 4.6 %, p?=?0.53).     

Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories

Our goal was to examine the trajectory of bonding impairment across the first 6 months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n?=?97) and a healthy control comparison group (CA?, n?=?53), participants completed questionnaires related to bonding with their infants at 6 weeks, 4 months, and 6 months postpartum and psychopathology at 6 months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6 months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother–infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother–infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors.     

Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates

Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1–11, 2009.     

Serum leptin level measured 48 h after delivery is associated with development of postpartum depressive symptoms: a 3-month follow-up study

The aim of this study was to assess the possible relationship between leptin status and postpartum depressive symptoms using serum levels of leptin collected 24–48 h after delivery in a cohort Chinese sample. Women delivering a full-term, singleton, and live-born infant in the period from August 2013 to March 2014 were enrolled immediately postpartum. A blood sample was obtained 24–48 h after childbirth to test serum levels of leptin. Participation consisted of a visit in an obstetric unit at 3 months after delivery. The Edinburgh Postnatal Depression Scale (EPDS), completed at 3 months postpartum, was used to classify each woman’s depression symptom severity. Demographic, obstetric, behavioral risk, mental health, and psychosocial factors were considered. Multiple logistic regression analyses were used to identify risk factors most predictive of postpartum depressive symptoms. During the study period, 407 individuals were included and completed follow-up. At 3 months, according to EPDS score, 53 women (13.0 %) were considered as postpartum depressive symptoms. Serum leptin levels in women with PPD were significantly greater than those in women without depressive symptoms (36.5 [IQR, 25.5–50.4] vs. 14.5 [IQR, 9.4–22.4]?ng/ml, P?<?0.0001). Based on the ROC curve, the optimal cutoff value of serum leptin levels as an indicator for predicting of depressive symptoms was projected to be 24.3 ng/mL, which yielded a sensitivity of 88.7 % and a specificity of 73.4 %, with the area under the curve at 0.867 (95 % CI, 0.817–0.916). In multivariate analysis, there was an increased risk of depressive symptoms associated with leptin levels ≥24.3 ng/ml (OR 8.234; 95 % CI, 3.572–15.876; P?<?0.0001) after adjusting for possible confounders. Elevated serum leptin levels at delivery could eventually serve as a biological marker for the prediction of depressive symptoms. These associations were independent of other possible variables.     

Infant sleep and feeding patterns are associated with maternal sleep,stress, and depressed mood in women with a history of major depressive disorder (MDD)

Our goal was to examine associations of infant sleep and feeding patterns with maternal sleep and mood among women at risk for postpartum depression. Participants were 30 women (age?±?SD?=?28.3?±?5.1 years) with a history of MDD (but not in a mood episode at enrollment) who completed daily sleep diaries, wore wrist actigraphs to estimate sleep, and had their mood assessed with the Hamilton Depression Rating Scale (HAM-D-17) during four separate weeks of the perinatal period (33 weeks pregnancy and weeks 2, 6, and 16 postpartum). They logged their infants’ sleep and feeding behaviors daily and reported postnatal stress on the Childcare Stress Inventory (CSI) at week 16. Mothers’ actigraphically estimated sleep showed associations with infant sleep and feeding patterns only at postpartum week 2. Shorter duration of the longest infant-sleep bout was associated with shorter maternal sleep duration (p?=?.02) and lower sleep efficiency (p?=?.04), and maternal sleep efficiency was negatively associated with the number of infant-sleep bouts (p?=?.008) and duration of infant feeding (p?=?.008). Neither infant sleep nor feeding was associated with maternal sleep at 6 or 16 weeks, but more disturbed infant sleep and more frequent feeding at 6 weeks were associated with higher HAM-D scores at 6 and 16 weeks and higher CSI scores. Sleep in the mother-infant dyad is most tightly linked in the early postpartum weeks, but mothers continue to experience disturbed sleep and infant sleep and feeding behaviors continue to be associated with mothers’ depressive symptoms and stress ratings as long as 16 weeks postpartum. These data imply that interventions designed to improve maternal sleep and postpartum mood should include both mothers and infants because improving infant sleep alone is not likely to improve maternal sleep, and poor infant sleep is linked to postpartum depression and stress.     

Effects of prenatal depressive symptoms on maternal and infant cortisol reactivity

Prenatal depression is associated with adverse offspring outcomes, and the prevailing mechanistic theory to account for mood-associated effects implicates alterations of the maternal and foetal hypothalamic-pituitary adrenal (HPA) axes. Recent research suggests that depression may be associated with a failure to attenuate cortisol reactivity during early pregnancy. The aim of the current study is to investigate whether this effect continues into mid and late gestation. A further aim is to test whether maternal prenatal cortisol reactivity directly predicts infant cortisol reactivity. One hundred three pregnant women were recruited during either the second or third trimester. Depressive symptoms were assessed by self-report, and maternal salivary cortisol responses to a stressor (infant distress film) were measured. Approximately 2 months after birth, mothers (n?=?88) reported postnatal depression and infant salivary cortisol responses to inoculation were measured. Prenatal depression was not associated with cortisol reactivity to acute stress in mid and late pregnancy. Similarly, neither prenatal depression nor maternal prenatal cortisol reactivity predicted infant cortisol reactivity to inoculation at 2 months. If the effects of prenatal depression on foetal and infant development are mediated by alterations of the maternal and foetal HPA axes, then early pregnancy may be a particularly vulnerable period. Alternatively, changes to HPA reactivity may not be as central to this association as previously thought.     

Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour

Hardly any research has examined the link between postpartum anxiety disorder and maternal bonding. This study examined if postpartum anxiety disorder and maternal bonding are related in the postpartum period. Thereby, subclinical depressive symptoms and specific aspects of an anxious symptomatology were also taken into consideration. The German sample of N?=?78 mother–infant dyads is composed of n?=?30 mothers with postpartum anxiety disorders but without major or minor depression according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) and n?=?48 healthy mothers. Subjects were interviewed with the Structured Clinical Interview for DSM-IV Disorders at an average infant age of M?=?4.1 months. Moreover, mothers filled out the Postpartum Bonding Questionnaire-16. The Anxiety Cognitions Questionnaire, the Body Sensations Questionnaire and the Mobility Inventory were chosen to assess different aspects of anxious symptomatology. To control for concurrent subclinical depressive symptoms, we used the German Edinburgh-Postnatal-Depression Scale. Mothers with postpartum anxiety disorder reported significantly lower bonding than healthy mothers. However, in a linear regression analysis, concurrent subclinical depressive symptoms and avoidance of anxiety-related situations in company explained 27 % of the overall variance in maternal bonding. The perceived lower bonding of mothers with anxiety disorder could be due to aspects of a concurrent subclinical depressive symptomatology. This notion emphasizes the need to target even mild depressive symptoms in the treatment of postpartum anxiety disorders. The outcomes also underline that the severity of anxious symptomatology, reflected by avoidance behaviour in company, puts the mother–infant bond at risk.     

Maternal postpartum behavior and the emergence of infant-mother and infant-father synchrony in preterm and full-term infants: the role of neonatal vagal tone

Relations between maternal postpartum behavior and the emergence of parent-infant relatedness as a function of infant autonomic maturity were examined in 56 premature infants (birthweight = 1000-1500 g) and 52 full-term infants. Maternal behavior, mother depressive symptoms, and infant cardiac vagal tone were assessed in the neonatal period. Infant-mother and infant-father synchrony, maternal and paternal affectionate touch, and the home environment were observed at 3 months. Premature birth was associated with higher maternal depression, less maternal behaviors, decreased infant alertness, and lower coordination of maternal behavior with infant alertness in the neonatal period. At 3 months, interactions between premature infants with their mothers and fathers were less synchronous. Interaction effects of premature birth and autonomic maturity indicated that preterm infants with low vagal tone received the lowest amounts of maternal behavior in the postpartum and the least maternal touch at 3 months. Infant-mother and infant-father synchrony were each predicted by cardiac vagal tone and maternal postpartum behavior in both the preterm and full-term groups. Among preterm infants, additional predictors of parent-infant synchrony were maternal depression (mother only) and the home environment (mother and father). Findings are consistent with evolutionary perspectives on the higher susceptibility of dysregulated infants to rearing contexts and underscore the compensatory mechanisms required for social-emotional growth under risk conditions for parent-infant bonding.     

Postpartum Maternal Sleep,Maternal Depressive Symptoms and Self-Perceived Mother–Infant Emotional Relationship

This study examined the links between maternal sleep, maternal depressive symptoms, and mothers’ perceptions of their emotional relationship with their infant in a self-recruited sample of mothers. Eighty mothers of infants 3–18 months old completed sleep diaries for 5 consecutive nights, and questionnaires assessing sleep (Insomnia Severity Index [ISI]), depressive symptom severity (Edinburgh Postnatal Depression Scale [EPDS]), and perceived mother–infant relationship (Postpartum Bonding Questionnaire [PBQ] and Maternal Postnatal Attachment Questionnaire [MPAQ]). Significant correlations, controlling for depression severity, were found between more disturbed maternal sleep and more negative maternal perceptions of the mother-infant relationship. Regression analyses revealed that EPDS showed the strongest association with PBQ, whereas ISI demonstrated the strongest association with MPAQ. The present study highlights the importance of deepening and expanding our understanding of the negative implications of maternal sleep problems.     

Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms

Pregnancy is a time of vulnerability for vitamin D insufficiency, and there is an emerging literature associating low levels of 25(OH)-vitamin D with depressive symptoms. However, the link between 25(OH)-vitamin D status in pregnancy and altered risk of postnatal depressive symptoms has not been examined. We hypothesise that low levels of 25(OH)-vitamin D in maternal serum during pregnancy will be associated with a higher incidence of postpartum depressive symptoms. We prospectively collected sera at 18 weeks gestation from 796 pregnant women in Perth (1989–1992) who were enrolled in the Western Australian Pregnancy Cohort (Raine) Study and measured levels of 25(OH)-vitamin D. Women reported postnatal depressive symptoms at 3 days post-delivery. Women in the lowest quartile for 25(OH)-vitamin D status were more likely to report a higher level of postnatal depression symptoms than women who were in the highest quartile for vitamin D, even after accounting for a range of confounding variables including season of birth, body mass index and sociodemographic factors. Low vitamin D during pregnancy is a risk factor for the development of postpartum depression symptoms.     

Prenatal predictors of postpartum depression and postpartum depressive symptoms in Mexican mothers: a longitudinal study

Prospective studies on the predictors of postpartum depression (PPD) in Latin America are scarce, which is a matter of importance, since the significance of PPD risk factors may vary according to the level of development of a country, the types of measurement and the time periods assessed. This study identifies the prenatal predictors for PPD (diagnostic interview) and postpartum depressive symptoms (PPDS) (self-report scale) in Mexican mothers at 6 weeks and 6 months postpartum. Two hundred and ten women were interviewed using the Structured Clinical Interview (SCID-I), Patient Health Questionnaire (PHQ-9) and various risk factor scales. Univariate logistic regressions showed that social support, marital satisfaction, life events, a history of psychopathology, anxiety symptoms, depressive symptoms, the traditional female role, previous miscarriages/termination of pregnancy and unplanned/unwanted pregnancy were significant predictors for both PPD and PPDS at both assessment times in the postpartum. Education, age, marital status, income, occupation, parity, C-section and resilience were significant for only one of the measurements and/or at just one assessment time. General findings replicate a high- and low-income country observed psychosocial risk profile and confirm a sociodemographic and obstetric profile of vulnerability that is more prevalent in resource-constrained countries. PPD constitutes a high burden for new mothers, particularly for those living in low-middle-income countries who face social disadvantages (such as low educational attainment and income).