Does Perinatal Depression begin before pregnancy?

Almost nine in 10 women with perinatal depressive symptoms have had similar mental health problems well before becoming pregnant. This new research from the Murdoch Children's Research Institute challenges an old idea that perinatal mental health problems are different to those at other times in life.

The study, which was published in The Lancet, assessed 1000 young women, aged between 14 and 29 years, for the presence of mental health problems on nine occasions over a 14 to 20 year period prior to conception. Pregnant women were then assessed in their 32nd week of pregnancy, at eight weeks postpartum and at the time of the child’s first birthday.

Perinatal depression is the collective name for depression which occurs either during pregnancy (known as antenatal depression), or after the birth of a baby (known as postnatal depression).

The study found two thirds of all mothers had a prior history of mental health problems at some point in adolescence. Overall there was a preconception history of mental health symptoms in 85 per cent of pregnancies with perinatal depressive symptoms.

Maternal perinatal depression is one of the clearest predictors of healthy emotional and intellectual development in children. Women who suffered from problems with depression and anxiety in adolescence through to young adulthood have a greater than one in three chance of having high levels of perinatal depressive symptoms.

This is in comparison to women in the study with no history of mental health problems who reported perinatal depression in one in 13 pregnancies.

Lead researcher, Professor George Patton said the study is unique as it found a stronger connection between mental health in life prior to getting pregnant, and perinatal depression.

“Our study investigated mental health for many years prior to conception and not just from the point at which a woman recognise she was pregnant like nearly all previous studies. The study further challenges a view of maternal perinatal depression as a unique problem related to the hormonal changes are pregnancy. For the great majority, perinatal depressive symptoms are best considered as a continuation or recurrence of problems beginning well before pregnancy.”

Researchers say the finding could help prevent depression during pregnancy by targeting the high risk group.

“The fact that perinatal depression overwhelmingly occurs in women who have had depression before is important. This suggests that greater attention to women who have a long history of mental health problems prior to pregnancy. Counselling and putting in place the right emotional and social supports for these women could be very helpful,” Professor Patton said.

“In many ways a healthy start to life begins in adolescents who are tomorrow’s parents. Responding to youth mental health problems is going to be an important strategy for preventing later maternal perinatal depression.”