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Cohort study of depressed mood during pregnancy and after childbirth

BMJ 2001; 323 doi: (Published 04 August 2001) Cite this as: BMJ 2001;323:257
  1. Jonathan Evans (j.evans{at}, consultant senior lectureraa,
  2. Jon Heron, research assistantb,
  3. Helen Francomb, midwifec,
  4. Sarah Oke, consultant psychiatristd,
  5. Jean Golding the Avon Longitudinal Study of Parents and Children Study Team., professor of paediatric epidemiologyb
  1. a Division of Psychiatry, University of Bristol, Bristol BS2 8DZ
  2. b Unit of Paediatric and Perinatal Epidemiology, Division of Child Health, University of Bristol, Bristol BS8 1TQ
  3. c Department of Women's Health and Care of the Newborn, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB
  4. d Mother and Baby Unit, Barrow Hospital, Barrow Gurney, Bristol BS48 3SG
  1. Correspondence to: J Evans
  • Accepted 19 April 2001


Objective: To follow mothers' mood through pregnancy and after childbirth and compare reported symptoms of depression at each stage.

Design: Longitudinal cohort study.

Setting: Avon.

Participants: Pregnant women resident within Avon with an expected date of delivery between 1 April 1991 and 31 December 1992.

Main outcome measures: Symptom scores from the Edinburgh postnatal depression scale at 18 and 32 weeks of pregnancy and 8 weeks and 8 months postpartum. Proportion of women above a threshold indicating probable depressive disorder.

Results: Depression scores were higher at 32 weeks of pregnancy than 8 weeks postpartum (difference in means 0.88, 95% confidence interval 0.79 to 0.97). There was no difference in the distribution of total scores or scores for individual items at the four time points. 1222 (13.5%) women scored above threshold for probable depression at 32 weeks of pregnancy, 821 (9.1%) at 8 weeks postpartum, and 147 (1.6%) throughout. More mothers moved above the threshold for depression between 18 weeks and 32 weeks of pregnancy than between 32 weeks of pregnancy and 8 weeks postpartum.

Conclusions: Symptoms of depression are not more common or severe after childbirth than during pregnancy. Research and clinical efforts need to be moved towards understanding, recognising, and treating antenatal depression.


  • Funding Medical Research Council, Wellcome Trust, Department of Health, Department of the Environment, and various charitable organisations and commercial companies. The ALSPAC study is part of the WHO initiated European longitudinal study of pregnancy and childhood.

  • Competing interests None declared.

  • Accepted 19 April 2001
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