Evolution of perinatal depressive symptoms from pregnancy to two years postpartum in a low-risk sample: the MATQUID cohort

Abstract

Background: Few studies have explored the evolution of perinatal depressive symptoms (PNDS) throughout the perinatal period.

Aims: To evaluate in a low-risk sample, whether different evolutive profiles of PNDS exist from pregnancy to 2-years postpartum, and whether the subgroups differ regarding psychopathological and demographic characteristics.

Methods: In a prospective, longitudinal study from 8 months pregnancy to 2 years postpartum, repeated measures of PNDS using the CES-D were performed on a sample of 579 women at low-risk for PNDS. First, semiparametric mixture models were used to identify groups of women with distinct trajectories of PNDS. Second, multinomial logistic regressions were used to identify risk factors for each group.

Results: Four distinct trajectories of PNDS evolution were found: (i) 72% of the women never presented with clinically significant depressive symptoms; (ii) 4% presented with depressive symptoms only during the postnatal period; (iii) 21% presented with depressive symptoms throughout the follow-up period, with a higher intensity during pregnancy; (iv) 3% presented with stable highly intense symptoms throughout the follow-up period. Psychosocial risk factors for PNDS were mainly identified in the patients of the third group, with an influence of socio-economical variables and anxiety traits.

Limitations: The main limitations of the present study are the small size of the sample and the low level of risk for PNDS, so the results cannot be extrapolated to all types of populations.

Conclusion: Different subtypes of evolutionary profiles of PNDS are found in a low-risk sample, and are associated with different profiles of risk factors.