Long-term trajectories of maternal depressive symptoms and their antenatal predictors

- The antenatal predictors of maternal depressive symptom trajectories were examined.
- The model included very low, low-stable, high-stable and intermittent trajectories.
- Antenatal depressive symptoms predicted the two high-symptom trajectories.
- The other antenatal predictors were specific for each high-symptom trajectory.

BackgroundDepressive symptoms, often long-term or recurrent, are common among mothers of young children and a well-known risk for child well-being. We aimed to explore the antecedents of the long-term trajectories of maternal depressive symptoms and to define the antenatal factors predicting the high-symptom trajectories.MethodsThe sample comprised 329 mothers from maternity centers. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) antenatally and at two months, six months, 4-5 years, 8-9 years and 16-17 years after delivery. Maternal expectations concerning the baby were assessed with the Neonatal Perception Inventory (NPI). Background information was gathered with questionnaires.ResultsA model including four symptom trajectories (very low, low-stable, high-stable and intermittent) was selected to describe the symptom patterns over time. The high-stable and the intermittent trajectory were both predicted pairwise by a high antenatal EPDS sum score as well as high EPDS anxiety and depression subscores but the other predictors were specific for each trajectory. In multivariate analyses, the high-stable trajectory was predicted by a high antenatal EPDS sum score, a high EPDS anxiety subscore, diminished life satisfaction, loneliness and more negative expectations of babies on average. The intermittent trajectory was predicted by a high antenatal EPDS sum score, a poor relationship with own mother and urgent desire to conceive.LimitationsOnly self-report questionnaires were used. The sample size was rather small.ConclusionsThe results suggest a heterogeneous course and background of maternal depressive symptoms. This should be considered in intervention planning.