Cohort study of depressed mood during pregnancy and after childbirth

doi:10.1136/bmj.323.7307.257

BMJ 2001;323:257-260 ( 4 August )

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Cohort study of depressed mood during pregnancy and after childbirth

Jonathan Evans, consultant senior lecturer, ^a Jon Heron, research assistant, ^b Helen Francomb, midwife, ^c Sarah Oke, consultant psychiatrist, ^d Jean Golding, professor of paediatric epidemiology, ^b on behalf of the Avon Longitudinal Study of Parents and Children Study Team.

^a Division of Psychiatry, University of Bristol, Bristol BS2 8DZ, ^b Unit of Paediatric and Perinatal Epidemiology, Division of Child Health, University of Bristol, Bristol BS8 1TQ, ^c Department of Women's Health and Care of the Newborn, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, ^d Mother and Baby Unit, Barrow Hospital, Barrow Gurney, Bristol BS48 3SG

Correspondence to: J Evans j.evans{at}bristol.ac.uk

Objective: To follow mothers' mood through pregnancyand after childbirth and compare reported symptoms of depressionat eachstage.
Design: Longitudinal cohortstudy.
Setting: Avon.
Participants: Pregnant women resident within Avon with anexpected date of delivery between 1 April 1991 and 31 December1992.
Main outcome measures: Symptom scores from the Edinburgh postnataldepression scale at 18 and 32 weeks of pregnancy and 8 weeks and8 months postpartum. Proportion of women above a threshold indicatingprobable depressivedisorder.
Results: Depression scores were higher at 32 weeksof pregnancy than 8 weeks postpartum (difference in means 0.88,95% confidence interval 0.79 to 0.97). There was no differencein the distribution of total scores or scores for individual itemsat the four time points. 1222 (13.5%) women scored above thresholdfor probable depression at 32 weeks of pregnancy, 821 (9.1%) at8 weeks postpartum, and 147 (1.6%) throughout. More mothers movedabove the threshold for depression between 18 weeks and 32 weeksof pregnancy than between 32 weeks of pregnancy and 8 weekspostpartum.
Conclusions: Symptoms of depression are not more commonor severe after childbirth than during pregnancy. Research andclinical efforts need to be moved towards understanding, recognising,and treating antenataldepression.

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