New research indicates that maternal depressive symptoms most likely begin during or before pregnancy and continue steadily throughout the perinatal and postnatal periods. The analysis of over 11,000 pregnant women with varying levels of depressive symptoms from different countries suggests that these symptoms start earlier and persist longer than commonly believed.
According to Michael J. Meaney, a professor at McGill University in Montreal and director of the Translational Neuroscience Program at A*STAR Singapore, the term “postnatal depression” contradicts both existing scientific literature and the experiences of clinicians who specialize in mental health disorders related to obstetric practice. He expressed surprise at how consistently this pattern was observed across multiple studies: “We expected that symptoms would primarily arise during prenatal stages and remain relatively stable; however, we found very little evidence supporting a postnatal onset.”
These findings imply that depressive symptoms emerge earlier than previously assumed, highlighting the importance of preventive measures within routine healthcare settings for women such as family medicine clinics.
Begin the process of screening earlier
The investigators thoroughly examined the progression and consistency of self-reported depressive symptoms at various intervals throughout the perinatal period among 11,563 pregnant women from seven cohorts in the United Kingdom, Canada, and Singapore. The average age of participants was 29 years; majority (87.6%) were White, while a small percentage were East Asian (4.9%) or Southeast Asian (2.6%).
The analysis carefully tracked depressive symptoms starting from before conception all the way through pregnancy up until two years after childbirth. In each cohort, three distinct groups of mothers were identified based on their level of depressive symptoms: low, mild, or high levels as determined by either the Edinburgh Postnatal Depression Scale (EPDS) or the Center for Epidemiological Studies Depression (CES-D).
Remarkably, it was observed that all mothers within every cohort exhibited consistent patterns of maternal depressive symptoms throughout both pregnancy and postpartum periods. Even those who surpassed clinically established thresholds for “probable” depression displayed stable trajectories from pregnancy to postnatal phase.
“These collective findings strongly indicate that maternal depressive symptom levels can be detected during pregnancy in community-based studies and persist into the postnatal stage,” state the authors confidently. “These results highlight early antenatal stages as crucial timeframes for identifying enduring paths of maternal depressive symptoms.” Public health policies should prioritize interventions targeting such symptoms during this critical period.”
Furthermore, these findings serve to reinforce recent efforts by American Psychiatric Association which now refers to postpartum depression as peripartum depression.
Additionally revealed in a recent paper documenting their discoveries is evidence suggesting that many individuals may experience signs of depression even prior to conceiving.
“Our research underscores how our findings ought to lead towards universally implementing prenatal screening practices,” asserted Meaney when discussing depression screenings typically conducted during mid-gestational visits in second trimester pregnancies. He further emphasized, “Our results combined with existing literature regarding its impact on child development clearly suggest that the timing of screening should be advanced to the earliest confirmation of pregnancy.”
Conclusion:
In conclusion, this new research sheds light on the importance of identifying and treating maternal depressive symptoms early on in the perinatal period. It is crucial for healthcare providers to recognize that these symptoms may begin before pregnancy and persist long after childbirth. By addressing these symptoms proactively, we can help improve the mental health and well-being of mothers, ultimately benefiting the entire family. Let us work towards creating a supportive environment for mothers during this critical time in their lives.
Reference: https://www.medscape.com/viewarticle/maternal-depressive-symptoms-may-start-pregnancy-2023a1000sie
