Predictors of recovery from prenatal depressive symptoms from pregnancy through postpartum

Abstract

Background: Identifying predictors of the course of depressive symptoms from pregnancy through postpartum is important to inform clinical interventions.

Methods: This longitudinal study investigated predictors of recovery from prenatal elevated depressive symptoms in the postpartum period. Forty-one pregnant women completed demographic, interpersonal, and psychosocial self-report assessment measures at 32 weeks of gestation and again 12 weeks postpartum.

Results: Of those with elevated depressive symptoms, defined as a Beck Depression Inventory-II (BDI-II) score ≥10, at the prenatal baseline, 39% (n=16) recovered to nonelevated symptom levels postpartum, whereas 61% (n=25) experienced sustained elevated symptoms. Women who recovered evidenced significantly lower baseline depression severity and more frequent engagement in physical activity and cohabitated with a romantic partner. In multiparous women (n=25), history of past postpartum depression (PPD) differentiated between those with transient and those with persisting symptoms, although history of lifetime depression did not. None of the additional demographic, interpersonal, or psychosocial variables investigated differentiated between groups. Logistic regression analysis showed prenatal depression severity and exercise frequency as predictors of recovery postpartum.

Conclusions: Results suggest most women will not experience spontaneous recovery. Women with prenatal heightened symptom severity and previous experiences with PPD are acutely vulnerable to experience sustained symptoms. In contrast, having a cohabitating partner and engagement in prenatal exercise predicted symptom improvement. Physical exercise may be an important clinical recommendation, as it may improve mood. Given the small sample size, these results are preliminary. Implications and future research recommendations are discussed.

FIG. 1.

Prenatal and postpartum Beck Depression Inventory-II (BD-II) symptom severity for recovered and sustained symptom groups.

FIG. 2.

Weekly exercise frequency for participants with recovered vs. sustained symptoms.