Developmental trajectories of pregnant and postpartum depression in an epidemiologic survey.

OBJECTIVE: To estimate the prevalence and determinants for the peripartum depression.

METHODS: Data were extracted from the 2 waves of the National Epidemiologic Study of Alcohol and Related Conditions (NESARC), a representative sample of the US population corresponding to 34,653 participants. All women pregnant during the year before the second assessment were included. Peripartum depression was evaluated according a semi-structured interview at Wave 2. Risk factors covering life from childhood through adulthood, and including sexual abuse, family history of depression and psychiatric disorder lifetime were evaluated at wave 1. Stressful life event and obstetric factors were evaluated for the period of 12 months preceding the second interview.

RESULTS: In the sample of 1085 participants pregnant at wave 2, the prevalence of peripartum depression was 10.8%. Women with a peripartum depression reported higher rates of sexual abuse in childhood (OR=3.07), family history of depression (OR=3.27). A history of mental disorder was associated with a higher rate of peripartum depression (OR=3.43) Four disorders were specifically associated with higher rate of peripartum depression including depression (OR=4.91), substance use disorder (OR=2.37), bipolar disorder (OR=2.39) and history of suicide attempt (OR=3.79). Peripartum depression was associated with stressful life event in the last year (OR=3.03), and complications during pregnancy (OR=2.10).

LIMITATIONS: Not distinguish between depressed women during pregnancy from postpartum depressed women.

CONCLUSION: Depression affects more than one in 10 women during peripartum. The factors associated with peripartum depression are traumatic, personal or family history of mental disorder, in a timeframe covering life from childhood through adulthood.