Late-pregnancy depression predicts postnatal woes

NEW YORK (Reuters Health) - Helping women who suffer from depression during pregnancy could reduce their risk of remaining depressed after giving birth and, in turn, reduce the level of stress they experience in early parenthood, Australian researchers report.

The strongest predictor of whether or not a woman would have postnatal depression was whether she was depressed shortly before giving birth, also known as the antenatal period, Drs. Bronwyn Leigh of Heidelberg Repatriation Hospital Austin Health in Heidelberg Heights and Jeannette Milgrom of the University of Melbourne found. And postnatal depression was, in turn, the only significant risk factor for high levels of parenting stress.

To date, research and treatment efforts have targeted postnatal depression, the researchers note, but less is known about risk factors for antenatal depression and early parenting stress.

To investigate the relationships of depression during pregnancy, postnatal depression, and parenting stress, Leigh and Milgrom looked at 367 pregnant women, all of whom completed several questionnaires at 26 to 32 weeks' pregnancy. A subset of 161 women repeated the questionnaires 10 to 12 weeks after giving birth.

The researchers identified seven significant risk factors for antenatal depression, with the strongest being antenatal anxiety, low self esteem and low levels of social support.

The strongest risk factor for whether or not a woman would report postnatal depression was whether she experienced antenatal depression, while parenting stress and a history of depression also increased risk. The only risk factor for parenting stress was postnatal depression.

Parenting stress and postnatal depression each appear to contribute to the other, Leigh and Milgrom write in BMC Psychiatry. And while antenatal depression doesn't directly contribute to parenting stress, they say, postnatal depression serves as a link between the two.

"Targeted interventions for antenatal and postnatal depression may reduce both the symptom severity and incidence of perinatal depression and assist in the amelioration or prevention of early parenting stress," the researchers conclude.

SOURCE: BMC Psychiatry, published online April 18, 2008.