Depression in women during pregnancy
Professor Rebecca Pearson explains that depression is at least as common during pregnancy as after birth, in our next #Co90sDiscoveries episode.
National guidance and health services for women have significantly improved after Children of the 90s-based studies revealed how common maternal depression is both during, as well as after, pregnancy.
Maternal depression: Supporting women during pregnancy
Many women struggle with anxiety and depression when starting a family – both before and after the baby is born. Children of the 90s studies showed for the first time that depression was at least as common during pregnancy as after birth. By providing clear evidence on mothers’ mental health, this discovery and others have prompted changes to national guidance and helped ensure that better support is available to women before they give birth.
Gathering mental health data in parents
Children of the 90s is ideally placed to help researchers better understand parental depression and its impact across generations.
As a birth cohort study, it uniquely started during pregnancy rather than after the children were born. Over subsequent decades, it has gathered a wealth of data such as personality characteristics, mental health, biological measurements, lifestyle factors and sociodemographic information.
A key set of mental health measures collected is the Edinburgh Postnatal Depression Scale (EPDS), which tracks the participants’ self-reported depressive symptoms and is the most widely used perinatal depression instrument globally. From the moment they were 18 weeks’ pregnant to the 21st birthdays of their children, the mothers and their partners have reported their depressive symptoms using the EPDS, at 10 different points in their children’s lives.
Using this detailed data, researchers were able to show for the first time that depression is at least as common in pregnancy as after birth. This provided healthcare and maternity support teams with a more accurate picture of the experiences of the current population. As the Children of the 90s grew older, another study found that teenagers of mothers who had been depressed during and shortly after pregnancy were at significant risk for a diagnosis of depression.
Maternal mental health declines in a generation
Now as an intergenerational study with three generations, Children of the 90s researchers have shown that depression in pregnancy is higher (25%) in the second generation of Children of the 90s’ mothers than it was in the first (17%).
This worrying 51% rise in anxiety and depressive symptoms was revealed by comparing data from 2,390 original mothers who gave birth in the early 1990s with 180 daughters who gave birth at the same age of 24. If their mother was depressed in pregnancy, daughters were also more than three times as likely to be depressed in their pregnancy.
Evidence for health services
“While our studies show mental health problems are rising, this may be partly due to greater awareness and less stigma,” says Professor Rebecca Pearson of Manchester Metropolitan University, and former Lecturer in Psychiatric Epidemiology at the University of Bristol. "Interestingly, today's young women report feeling increasingly overwhelmed and stressed rather feeling down and flat. But since we know that depression in pregnancy has substantial impact to both mother and child in later years, this is of key importance for health services.”
Our findings have contributed to routine NHS screening for depression in pregnancy, more antenatal visits by health visitors and ongoing campaigns for perinatal mental health teams specifically. Scientifically, this research has furthered understanding about the potential role of prenatal stress and parenting behaviour.
Professor Pearson adds: “There are still many unanswered questions regarding depression in mothers and partners. It’s important that pregnant women don’t feel stigma or blame themselves for any impact on the child. Working with local children’s centres, we encourage the registration of new parents in pregnancy, to offer them support as early as possible.”
- Prevalence of Prenatal Depression Symptoms Among 2 Generations of Pregnant Mothers: The Avon Longitudinal Study of Parents and Children
- Depression during pregnancy rises in a generation
- Association of Persistent and Severe Postnatal Depression with Child Outcomes
- Postnatal depression has greater impact on children’s development when it is persistent and severe
- We Don’t Talk Enough About Depression During Pregnancy and It May Be On The Rise
- Maternal and paternal depression and child mental health trajectories: evidence from the Avon Longitudinal Study of Parents and Children
- Maternal depression and its impact on child development
- BMJ Cohort study of depressed mood during pregnancy and after childbirth
What we discovered
Depression is at least as common during pregnancy, as it is after birth.Ante-natal depression carries risks to the mental health of the child, that continues in adulthood.
- Anxiety and depressive symptoms during pregnancy have risen by 51 per cent within a generation.
- Research using Children of the 90s data is cited in national NHS documents and national guidance on perinatal mental health.
- The study has helped raise awareness of ante-natal depression, reducing the sense of isolation that some women might feel and helping them realise that many others feel the same.