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Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents

IMPORTANCE: Depressive symptoms during pregnancy influence the development and health of the offspring, underscoring the need for timely intervention. However, the course of depressive symptoms across the perinatal period remains unclear, thus complicating screening and referral guidelines. OBJECTIV...

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Autores principales: Kee, Michelle Z. L., Cremaschi, Andrea, De Iorio, Maria, Chen, Helen, Montreuil, Tina, Nguyen, Tuong Vi, Côté, Sylvana M., O’Donnell, Kieran J., Giesbrecht, Gerald F., Letourneau, Nicole, Chan, Shiao Yng, Meaney, Michael J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603499/
https://www.ncbi.nlm.nih.gov/pubmed/37883082
http://dx.doi.org/10.1001/jamanetworkopen.2023.39942
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author Kee, Michelle Z. L.
Cremaschi, Andrea
De Iorio, Maria
Chen, Helen
Montreuil, Tina
Nguyen, Tuong Vi
Côté, Sylvana M.
O’Donnell, Kieran J.
Giesbrecht, Gerald F.
Letourneau, Nicole
Chan, Shiao Yng
Meaney, Michael J.
author_facet Kee, Michelle Z. L.
Cremaschi, Andrea
De Iorio, Maria
Chen, Helen
Montreuil, Tina
Nguyen, Tuong Vi
Côté, Sylvana M.
O’Donnell, Kieran J.
Giesbrecht, Gerald F.
Letourneau, Nicole
Chan, Shiao Yng
Meaney, Michael J.
author_sort Kee, Michelle Z. L.
collection PubMed
description IMPORTANCE: Depressive symptoms during pregnancy influence the development and health of the offspring, underscoring the need for timely intervention. However, the course of depressive symptoms across the perinatal period remains unclear, thus complicating screening and referral guidelines. OBJECTIVE: To examine the course and stability of depressive symptoms across the perinatal period in multiple, ethnically diverse independent observational cohorts. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included self-reported depressive symptoms at multiple time points from 7 prospective cohorts spanning 3 continents (United Kingdom: Avon Longitudinal Study of Parents and Children from 1991 to 1995; Canada: Maternal Adversity, Vulnerability and Neurodevelopment from 2003 to 2007; Montreal Antenatal Well-being Study from 2019 to 2022; Alberta Pregnancy Outcomes and Nutrition from 2009 to 2014; and Singapore: Growing Up in Singapore Toward Healthy Outcomes from 2009 to 2013; Singapore Preconception Study of Long-Term Maternal and Child Outcomes from 2015 to 2019; and Mapping Antenatal Maternal Stress from 2019 to 2022). Participants were recruited either during preconception or pregnancy and observed into the postnatal period. All data from each cohort were analyzed from July 2022 to April 2023. MAIN OUTCOMES AND MEASURES: Self-reported depressive symptoms from pregnancy to 2 years following childbirth using either the Edinburgh Postnatal Depression Scale or the Center for Epidemiological Studies Depression were analyzed independently within each cohort using item response theory (IRT) techniques. K-means clustering was used to identify groups of participants with similar trajectories. RESULTS: A total of 11 563 pregnant women (mean [SD] age, 29 [5] years; 569 [4.9%] East Asian women; 304 [2.6%] Southeast Asian women; 10 133 [87.6%] White women) self-reported depressive symptoms from pregnancy to 2 years following childbirth. Analytic methods from Item Response Theory identified 3 groups of mothers based on depressive symptoms: low, mild, and high levels in each of the 7 cohorts. Mothers within and across all cohorts had stable trajectories of maternal depressive symptoms from pregnancy onwards. Mothers with clinical levels of depressive symptoms likewise showed stable trajectories from pregnancy into the postnatal period. CONCLUSIONS AND RELEVANCE: In this study, trajectories of depressive symptoms remained stable from pregnancy across the perinatal period, a finding that conflicts with a continuing emphasis on postpartum or postnatal onset of depression that persists in some health policy guidelines. Interventions and public health initiatives should focus on reducing depressive symptoms during pregnancy in addition to following birth.
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spelling pubmed-106034992023-10-28 Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents Kee, Michelle Z. L. Cremaschi, Andrea De Iorio, Maria Chen, Helen Montreuil, Tina Nguyen, Tuong Vi Côté, Sylvana M. O’Donnell, Kieran J. Giesbrecht, Gerald F. Letourneau, Nicole Chan, Shiao Yng Meaney, Michael J. JAMA Netw Open Original Investigation IMPORTANCE: Depressive symptoms during pregnancy influence the development and health of the offspring, underscoring the need for timely intervention. However, the course of depressive symptoms across the perinatal period remains unclear, thus complicating screening and referral guidelines. OBJECTIVE: To examine the course and stability of depressive symptoms across the perinatal period in multiple, ethnically diverse independent observational cohorts. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included self-reported depressive symptoms at multiple time points from 7 prospective cohorts spanning 3 continents (United Kingdom: Avon Longitudinal Study of Parents and Children from 1991 to 1995; Canada: Maternal Adversity, Vulnerability and Neurodevelopment from 2003 to 2007; Montreal Antenatal Well-being Study from 2019 to 2022; Alberta Pregnancy Outcomes and Nutrition from 2009 to 2014; and Singapore: Growing Up in Singapore Toward Healthy Outcomes from 2009 to 2013; Singapore Preconception Study of Long-Term Maternal and Child Outcomes from 2015 to 2019; and Mapping Antenatal Maternal Stress from 2019 to 2022). Participants were recruited either during preconception or pregnancy and observed into the postnatal period. All data from each cohort were analyzed from July 2022 to April 2023. MAIN OUTCOMES AND MEASURES: Self-reported depressive symptoms from pregnancy to 2 years following childbirth using either the Edinburgh Postnatal Depression Scale or the Center for Epidemiological Studies Depression were analyzed independently within each cohort using item response theory (IRT) techniques. K-means clustering was used to identify groups of participants with similar trajectories. RESULTS: A total of 11 563 pregnant women (mean [SD] age, 29 [5] years; 569 [4.9%] East Asian women; 304 [2.6%] Southeast Asian women; 10 133 [87.6%] White women) self-reported depressive symptoms from pregnancy to 2 years following childbirth. Analytic methods from Item Response Theory identified 3 groups of mothers based on depressive symptoms: low, mild, and high levels in each of the 7 cohorts. Mothers within and across all cohorts had stable trajectories of maternal depressive symptoms from pregnancy onwards. Mothers with clinical levels of depressive symptoms likewise showed stable trajectories from pregnancy into the postnatal period. CONCLUSIONS AND RELEVANCE: In this study, trajectories of depressive symptoms remained stable from pregnancy across the perinatal period, a finding that conflicts with a continuing emphasis on postpartum or postnatal onset of depression that persists in some health policy guidelines. Interventions and public health initiatives should focus on reducing depressive symptoms during pregnancy in addition to following birth. American Medical Association 2023-10-26 /pmc/articles/PMC10603499/ /pubmed/37883082 http://dx.doi.org/10.1001/jamanetworkopen.2023.39942 Text en Copyright 2023 Kee MZL et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Kee, Michelle Z. L.
Cremaschi, Andrea
De Iorio, Maria
Chen, Helen
Montreuil, Tina
Nguyen, Tuong Vi
Côté, Sylvana M.
O’Donnell, Kieran J.
Giesbrecht, Gerald F.
Letourneau, Nicole
Chan, Shiao Yng
Meaney, Michael J.
Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents
title Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents
title_full Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents
title_fullStr Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents
title_full_unstemmed Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents
title_short Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents
title_sort perinatal trajectories of maternal depressive symptoms in prospective, community-based cohorts across 3 continents
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603499/
https://www.ncbi.nlm.nih.gov/pubmed/37883082
http://dx.doi.org/10.1001/jamanetworkopen.2023.39942
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