Different trajectories of depressive symptoms during pregnancy

Abstract

ackground:Up to 10–15% of women experience high levels of depressive symptoms during pregnancy. Sincethese levels of symptoms can vary greatly over time, the current study investigated the existence of possiblelongitudinal trajectories of depressive symptoms during pregnancy, and aimed to identify factors associated withthese trajectories.Methods:Depressive symptoms were assessed prospectively at each trimester in 1832 women, using theEdinburgh (Postnatal) Depression Scale (E(P)DS). Growth mixture modeling was used to identify trajectories ofdepressive symptoms during pregnancy.Results:Three trajectories of depressive symptoms (E(P)DS scores) were identified: low stable (class 1, referencegroup, 83%), decreasing (class 2, 7%), and increasing (class 3, 10%). Classes 2 and 3 had significantly highermean E(P)DS scores (7–13 throughout pregnancy) compared to the reference group (stable; E(P)DS <4). Factorsassociated with trajectories 2 and 3 included previous depressive episodes, life events during pregnancy, andunplanned pregnancy. Notably, the only factor distinguishing classes 2 and 3 was the perception of partnerinvolvement experienced by women during their pregnancies. Class 2 (with decreasing E(P)DS scores) reportedhigh partner involvement, while class 3 (with increasing E(P)DS scores) reported poor partner involvementthroughout pregnancy.Limitations:Depressive symptoms were assessed by self-report rather than a diagnostic interview. The partici-pants were more often both highly educated and of Caucasian ethnicity compared to the general Dutch popu-lation.Conclusions:Poor partner involvement was associated with increasing depressive symptoms during pregnancy.Health professionals should focus on partner involvement during pregnancy in order to identify women who arepotentially vulnerable for perinatal depression.