A lifespan perspective on depression in the postpartum period in a racially and socioeconomically diverse sample of young mothers

• Type of Material: Article
• Authors: Alison E Hipwell, University of Pittsburgh; Irene Tung, University of Pittsburgh; Robert T Krafty, Emory University; Audrey W Leong, University of Pittsburgh; Meredith Spada, University of Pittsburgh; Hope Vaccaro, Case Western University; Sarah C Homitsky, Allegheny Health Network, Pittsburgh; Eydie Moses-Kolko, University of Pittsburgh; Kate Keenan, University of Chicago
• Language: English
• Date: 2022-05-06
• Publisher: CAMBRIDGE UNIV PRESS
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1017/S0033291722001210
• Title of Journal or Parent Work: PSYCHOLOGICAL MEDICINE
• Volume: 53
• Issue: 10
• Start Page: 4415
• End Page: 4423
• Grant/Funding Information: This work was supported by the National Institutes of Health (R01 MH071790, R01 HD067185, R01 MH106570). During the preparation of this manuscript, I.T. received support from a training grant from the National Institute on Alcohol Abuse and Alcoholism (T32 AA00745) and an early career development award from the National Institute of Mental Health (K01 MH123505). The content is solely the responsibility of the authors and does not necessarily represent the official views the funding organization.
• Keywords: Psychiatry; Life Sciences & Biomedicine; MENTAL-HEALTH OUTCOMES; POSTNATAL DEPRESSION; preconception; Social Sciences; lifespan; Psychology; postpartum depression; PERINATAL DEPRESSION; DISORDERS; Pittsburgh Girls Study; Psychology, Clinical; STRESS; ADOLESCENCE; PREVALENCE; RISK-FACTORS; SYMPTOMS; SUBTHRESHOLD DEPRESSION; Cumulative effects; Science & Technology
• Research Categories: Education, Social Sciences; Psychology, Clinical; Biology, Neuroscience; Biology, Biostatistics

Abstract

Background Consistent evidence from retrospective reports and case registry studies indicates that a history of depression is a major risk factor for depression in the peripartum period. However, longitudinal studies with racially and socioeconomically diverse samples of young mothers are lacking, and little is known about developmental patterns of depression across the lifespan that can inform preventive interventions. Methods Young primiparous mothers (n = 399, 13-25 years, 81% Black) were recruited from a population-based prospective study that began in childhood. Women reported on depression symptoms for at least 3 years prior to their pregnancy, during pregnancy, and at 4 months postpartum. Linear regression models were used to estimate change in pre-pregnancy depression severity and to evaluate associations between patterns of lifetime history and postpartum depression symptoms. Results Results revealed high levels of continuity in depression from pregnancy to postpartum, and across multiple years pre-pregnancy to postpartum. Overall, depression severity leading up to pregnancy decreased over time, but patterns of worsening or improving symptoms were not associated with depression severity in the postpartum period. Instead, area under the pre-pregnancy trajectory curve, representing cumulative lifetime depression burden, was uniquely associated with postpartum depression after adjusting for prenatal depression severity. Conclusions Depression in the postpartum period should be considered within a lifespan perspective of risk that accumulates before conception. Clinical screening and early interventions are needed in adolescence and young adulthood to prevent the onset and persistence of depressive symptoms that could have long-term implications for peripartum health.