Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-14T22:14:14.408Z Has data issue: false hasContentIssue false

Prevalence of Mood Symptoms and Depressions During Pregnancy: Implications for Clinical Practice and Research

Published online by Cambridge University Press:  07 November 2014

Abstract

A review of the literature demonstrates that the incidence of new mental disorders and their prevalence during pregnancy is similar to the 12-month incidence of mental disorders in women during other periods of their lives. The prevalence of severe mood, behavior, and cognitive symptoms during pregnancy is rather high. Severe mental symptoms during pregnancy have been reported to be associated with an increased rate of complications during pregnancy and delivery, preterm deliveries, low birth weight, a higher rate of postpartum depression, and a longer-term impact on the offspring's development. Several pre-pregnancy risk factors to develop dysphoric symptoms have been reported, but their utility for primiparous women with no previous history of mental disorders is unclear. The association of mental symptoms with general symptoms and biological changes during pregnancy is also unclear. Given the short- and long-term impact of dysphoric symptoms and stress during pregnancy on mother and child, efficacious, efficient, and safe prevention and treatment modalities are essential and achievable. Clarification of the nature and phenotyping of mental and general symptoms during pregnancy is an important step for the development of effective interventions.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Kessler, RC, McGonagle, KA, Swartz, M, Blazer, DG, Nelson, CB. Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. J Affect Disord. 1993;29:8596.CrossRefGoogle ScholarPubMed
2.Weissman, MM, Bland, R, Joyce, PR, et al.Sex Differences in rates of depression: cross-national perspectives. J Affect Disord. 1993;29:7784.CrossRefGoogle ScholarPubMed
3.Burke, KC, Burke, JD, Regier, DA. Age at onset of selected mental disorders in five community populations. Arch Gen Psychiatry. 2002;47:511518.CrossRefGoogle Scholar
4.Wolk, SI, Weissman, MM. Women and depression: an update. In: Oldham, JM, Riba, MB, eds. Review of Psychiatry, vol 14. Washington, DC: American Psychiatric Press; 1995.Google Scholar
5.Wu, LT, Anthony, JC. The estimated rate of depressed mood in US adults: recent evidence for a peak later in life. J Affect Disord. 2000;60:159171.CrossRefGoogle Scholar
6.Angst, J. Gender differences in affective disorders. In: Genazzan, AR, ed. Hormonal Replacement Therapy (HRT) in Climacteric and Aging Brain. Carnforth, United Kingdonm: Parthenon Publications; 2003.Google Scholar
7.Halbreich, U, Lumley, LA. The multiple interactional biological processes that might lead to depression and gender differences in its appearance. J Affect Disord. 1993;29:159173.CrossRefGoogle ScholarPubMed
8.Barnet, B, Joffe, A, Duggan, AK, Wilson, MD, Repke, JT. Depressive symptoms, stress, and social support in pregnant and postpartum adolescents. Arch Pediatr Adolesc Med. 1996;150:6469.CrossRefGoogle ScholarPubMed
9.Hoffman, S, Hatch, MC. Deptessive symptomatology during pregnancy: evidence for an association with decreased fetal growth in pregnancies of lower social Class women. Health Psychol. 2000;19:535543.CrossRefGoogle ScholarPubMed
10.Lindgren, K. Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Res Nurs Health. 2001;24:203217.CrossRefGoogle ScholarPubMed
11.Wu, J, Viguera, A, Riley, L, Cohen, L, Ecker, J. Mood disturbance in pregnancy and the mode of delivery. Am J Obsetet Gynecol. 2002;187:864867.CrossRefGoogle ScholarPubMed
12.Marcus, SM, Flynn, HA, Blow, FC, Barry, KL. Depressive symptoms among pregnant women screened in obstetrics settings. J Womens Health (Larchmt). 2003;12:373380.CrossRefGoogle ScholarPubMed
13.Zayas, LH, Cunningham, M, McKee, MD, Jankowski, KR. Depression and negative life events among pregnant African-American and Hispanic women. Womens Health Issues. 2002;12:1622.CrossRefGoogle ScholarPubMed
14.Terry, DJ, Mayocchi, L, Hynes, GJ. Depressive symptomatology in new mothers: a stress and coping perspective. J Abnorm Psychol. 1996;105:220231.CrossRefGoogle ScholarPubMed
15.Atkinson, AK, Rickel, AU. Postpartum depression and primiparous parents. J Abnorm Psychol. 1984;93:115119.CrossRefGoogle ScholarPubMed
16.Wiemann, CM, Berenson, AB, Wagner, KD, Landwehr, BM. Prevalence and correlates of psychopathology in pregnant adolescents. J Adolesc Health. 1996;18:3543.CrossRefGoogle ScholarPubMed
17.Holcomb, WL, Stone, LS, Lustman, PJ, Gavard, JA, Mostello, DJ. Screening for depression in pregnancy: characteristics of the Beck Depression Inventory. Obstet Gynecol. 1996;88:10211025.Google ScholarPubMed
18.O'Hara, MW. Social support, life events, and depression during pregnancy and the puerperium. Arch Gen Psychiatry. 1986;43:569573.CrossRefGoogle ScholarPubMed
19.O'Hara, MW, Zekoski, EM, Phillips, LH, Wright, EJ. Controlled prospective study of postpartum mood disorders: comparison of childbearing and nonchildbearing women. J Abnorm Psychol. 1990;99:315.CrossRefGoogle ScholarPubMed
20.Hobfoll, SE, Ritter, C, Lavin, J, Hulsizer, MR, Cameron, RP. Depression prevalence and incidence among inner-city pregnant and postpartum women. J Consult Clin Psychol. 1995;63:445453.CrossRefGoogle ScholarPubMed
21.Kelly, RH, Zatzick, DF, Anders, TF. The detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics. Am J Psychiatry. 2001;158:213219.CrossRefGoogle ScholarPubMed
22.Zlotnick, C, Johnson, SL, Miller, IW, Peralstein, T, Howard, M. Postpartum depression in women receiving public assistance: pilot study of an interpersonal-therapy-oriented group intervention. Am J Psychiatry. 2001;158:638640.CrossRefGoogle ScholarPubMed
23.Kelly, RH, Danielson, BH, Zatzick, DF, et al.Chart-recorded psychiatric diagnoses in women giving birth in California in 1992. Am J Psychiatry. 1999;156:955957.CrossRefGoogle ScholarPubMed
24.Seguin, L, Potvin, L, St. Denis, M, Loiselle, J. Chronic stressors, social support, and depression during pregnancy. Obstet Gynecol. 1995;85:583589.CrossRefGoogle ScholarPubMed
25.Gotlib, IH, Whiffen, VE, Mount, JH, Milne, K, Cordy, NI. Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. J Consult Clin Psychol. 1989;57:269274.CrossRefGoogle ScholarPubMed
26.Da Costa, D, Larouche, J, Dritsa, M, Brender, W. Psychosocial correlates of prepartum and postpartum depressed mood. J Affect Disord. 2000;59:3140.CrossRefGoogle ScholarPubMed
27.Gotlib, IH, Whiffen, VE, Wallace, PM, Mount, JH. Prospective investigation of postpartum depression: factors involved in onset and recovery. J Abnorm Psychol. 1991;100:122132.CrossRefGoogle ScholarPubMed
28.Ayers, S, Pickering, AD. Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth. 2001;28:111118.CrossRefGoogle ScholarPubMed
29.Cox, JL, Connor, Y, Kendell, RE. Prospective study of the psychiatric disorders of childbirth. Br J Psychiatry. 1982;140:111117.CrossRefGoogle ScholarPubMed
30.Kumar, R, Robson, KM. A prospective study of emotional disorders in childbearing women. Br J Psychiatry. 1984;144:3547.CrossRefGoogle ScholarPubMed
31.Watson, JP, Elliot, SA, Rugg, AJ, Brough, DI. Psychiatric disorder in pregnancy and the first postnatal year. Br J Psychiatry. 1984;144:453462.CrossRefGoogle ScholarPubMed
32.Cooper, PJ, Campbell, EA, Day, A, Kennerley, H, Bond, A. Non-psychotic psychiatric disorder after childbirth: a prospective study of prevalence, incidence, course and nature. Br J Psychiatry. 1988;152:799806.CrossRefGoogle ScholarPubMed
33.Evans, J, Heron, J, Francomb, H, Oke, S, Golding, J. Cohort study of depressed mood during pregnancy and after childbirth. Br J Psychiatry. 2001;323:257260.Google ScholarPubMed
34.Grazioli, R, Terry, DJ. The role of cognitive vulnerability and stress in the prediction of postpartum depressive symptomatology. Br J Clin Psychol. 2000;39:329347.CrossRefGoogle ScholarPubMed
35.Kermode, M, Fisher, J, Jolley, D. Health insurance status and mood during pregnancy and following birth: a longitudinal study of multiparous women. Aust N Z J Psychiatry. 2000;34:664670.CrossRefGoogle ScholarPubMed
36.Hedin, LW, Janson, PO. Domestic violence during pregnancy. Acta Obstet Gynecol Scand 2000;79:625630.Google ScholarPubMed
37.Josefsson, A, Berg, G, Nordin, C, Sydsjo, G. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand. 2001;80:251255.CrossRefGoogle ScholarPubMed
38.Hedegard, M, Henriksen, TB, Sabroe, S, Secher, NJ. Psychological distress in pregnancy and preterm delivery. BMJ. 1993;307:234239.CrossRefGoogle Scholar
39.Chung, TK, Lau, TK, Yip, AS, Chiu, HF, Lee, DT. Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med. 2001:63:830834.CrossRefGoogle ScholarPubMed
40.Patel, V, Rodrigues, M, DeSouza, N. Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Am J Psychiatry. 2002;159:4347.CrossRefGoogle ScholarPubMed
41.Areias, MEG, Kumas, R, Barros, H, Figueiredo, E. Comparative incidence of depression in women and nen, during pregnancy and after childbirth: validation of the Edinburgh Postnatal Depression Scale in Portuguese mothers. Br J Psychiatry. 1996;169:3035.CrossRefGoogle Scholar
42.Weissman, MM, Olfson, M. Depression in women: implications for health care research. Science. 1995;269:799801.CrossRefGoogle ScholarPubMed
43.Bolton, HL, Hughes, PM, Turton, P, Sedgwick, P. Incidence and demographic correlates of depressive symptoms during pregnancy in an inner London population. J Psychosom Obstet Gynaecol. 1998;19:202209.CrossRefGoogle Scholar
44.Coyne, JC, Pepper, CM, Flynn, H. Significance of prior episodes of depression in two patient populations. J Consult Clin Psychol. 1999;67:7681.CrossRefGoogle ScholarPubMed
45.Frank, E, Kupfer, DJ, Perel, JM, et al.Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry. 1990;47:10931099.CrossRefGoogle ScholarPubMed
46.Altshuler, LL, Hendrick, V, Cohen, LS. Course of mood and anxiety disorders during pregnancy and the postpartum period. J Clin Psychiatry. 1998;59(suppl 2):2933.Google ScholarPubMed
47.Murray, D, Cox, JL, Chapman, G, et al.Childbirth: life event or start of a long-term difficulty? further data from the Stoke-on-Trent controlled study of postnatal depression. Br J Psychiatry. 1995;166:595600.CrossRefGoogle ScholarPubMed
48.Pajulo, M, Savonlahti, E, Sourander, A, Helenius, H, Piha, J. Antenatal depression, substance dependency and social support. J Affect Disord. 2001;65:937.CrossRefGoogle ScholarPubMed
49.Hanna, EZ, Faden, VB, Dufour, MC. The motivational correlates of drinking, smoking, and illicit drug use during pregnancy. J Subst Abuse. 1994;6:155167.CrossRefGoogle ScholarPubMed
50.Zhu, SH, Valbo, A. Depression and smoking during pregnancy. Addict Behav. 2002;27:649658.CrossRefGoogle ScholarPubMed
51.Kessler, R, McGonagle, K, Zhao, S, et al.Lifetime and 12 month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:819.CrossRefGoogle ScholarPubMed
52.Judd, LL, Akiskal, HS, Zeller, PJ, et al.Psychosocial disability during the long-term course of unipolar major depressive disorder. Arch Gen Psychiatry. 2000;57:375380.CrossRefGoogle ScholarPubMed
53.Rapaport, MH, Lewis, L, Judd, MD, et al.A descriptive analysis of minor depression. Am J Psychiatry. 2002;159:637643.CrossRefGoogle ScholarPubMed
54.Judd, LL, Martin, PP, Wells, KB, Rapaport, MH. Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. Am J Psychiatry. 1996;153:14111417.Google Scholar
55.Weinberg, MK, Tronick, EZ, Beeghly, M, Olson, KL, Kernan, H, Riley, JM. Subsyndromal depressive symptoms and major depression in postpartum women. Am J Orthopsychiatry. 2001;71:8797.CrossRefGoogle ScholarPubMed
56.Steer, RA, Scholl, TO, Hediger, ML, Fischer, RL. Self-reported depression and negative pregnancy outcomes. J Clin Epidemiol. 1992;45:10931099.CrossRefGoogle ScholarPubMed
57.Kurki, T, Hiilesmaa, V, Raitasalo, R, Mattila, H, Ylikorkala, O. Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol. 2000;95:487490.Google ScholarPubMed
58.Lobel, M, Dunkel-Schetter, C, Scrimshaw, SC. Prenatal maternal stress and prematurity: a prospective study of socioeconomically disadvantaged women. Health Psychol. 1992;11:3240.CrossRefGoogle ScholarPubMed
59.Wadhwa, PD, Sandman, CA, Porto, M, Dunkel-Schetter, C, Garite, TJ. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol. 1993;169:858865.CrossRefGoogle ScholarPubMed
60.Cohen, LS, Rosenbaum, JF, Heller, VL. Panic attack-associated placental abruption: a case report. J Clin Psychiatry. 1989;50:266267.Google ScholarPubMed
61.Istvan, J. Stress, anxiety, and birth outcome: a critical review of the evidence. Psychological Bulletin. 1986;100:331348.CrossRefGoogle ScholarPubMed
62.Perkin, MR, Bland, JM, Peacock, JL, Anderson, HR. The effect of anxiety and depression during pregnancy on obstetric complications. Br J Obstet Gynaecol. 1993;100:629634.CrossRefGoogle ScholarPubMed
63.Orr, ST, Miller, CA. Maternal depressive symptoms and the risk of poor pregnancy outcome. Review of the literature and preliminary findings. Epidemiol Rev. 1995;17:165171.CrossRefGoogle ScholarPubMed
64.Cooper, PJ, Murray, L. Postnatal depression. BMJ. 1998;316:18841886.CrossRefGoogle ScholarPubMed
65.Wisner, KL, Zarin, DA, Holmboe, ES, et al.Risk-benefit decision making for treatment of depression during pregnancy. Am J Psychiatry. 2000;157:19331940.CrossRefGoogle ScholarPubMed