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Psychol Med DOI:10.1017/S0033291717002549

Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender.

Publication TypeJournal Article
Year of Publication2018
AuthorsDenckla, CA, Mancini, AD, Consedine, NS, Milanovic, SM, Basu, A, Seedat, S, Spies, G, Henderson, DC, Bonanno, GA, Koenen, KC
JournalPsychol Med
Date Published2018 05
KeywordsAdult, Depression, Depression, Postpartum, Diagnosis, Differential, Educational Status, Female, Humans, Logistic Models, Longitudinal Studies, Male, Maternal Age, Pregnancy, Psychiatric Status Rating Scales, Resilience, Psychological, Severity of Illness Index, Sex Factors, Stress, Psychological, Time Factors, Young Adult

BACKGROUND: Distinguishing temporal patterns of depressive symptoms during pregnancy and after childbirth has important clinical implications for diagnosis, treatment, and maternal and child outcomes. The primary aim of the present study was to distinguish patterns of chronically elevated levels of depressive symptoms v. trajectories that are either elevated during pregnancy but then remit after childbirth, v. patterns that increase after childbirth.

METHODS: The report uses latent growth mixture modeling in a large, population-based cohort (N = 12 121) to investigate temporal patterns of depressive symptoms. We examined theoretically relevant sociodemographic factors, exposure to adversity, and offspring gender as predictors.

RESULTS: Four distinct trajectories emerged, including resilient (74.3%), improving (9.2%), emergent (4.0%), and chronic (11.5%). Lower maternal and paternal education distinguished chronic from resilient depressive trajectories, whereas higher maternal and partner education, and female offspring gender, distinguished the emergent trajectory from the chronic trajectory. Younger maternal age distinguished the improving group from the resilient group. Exposure to medical, interpersonal, financial, and housing adversity predicted membership in the chronic, emergent, and improving trajectories compared with the resilient trajectory. Finally, exposure to medical, interpersonal, and financial adversity was associated with the chronic v. improving group, and inversely related to the emergent class relative to the improving group.

CONCLUSIONS: There are distinct temporal patterns of depressive symptoms during pregnancy, after childbirth, and beyond. Most women show stable low levels of depressive symptoms, while emergent and chronic depression patterns are separable with distinct correlates, most notably maternal age, education levels, adversity exposure, and child gender.


Alternate JournalPsychol Med
PubMed ID28889814
PubMed Central IDPMC5845817
Grant ListMC_PC_15018 / / Medical Research Council / United Kingdom
R21 HD085849 / HD / NICHD NIH HHS / United States
102215/2/13/2 / / Wellcome Trust / United Kingdom