Elsevier

The Lancet

Volume 386, Supplement 2, 13 November 2015, Page S22
The Lancet

Meeting Abstracts
Maternal depression in the 5 years after childbirth among women with and without perinatal depression: a population-based cohort study

https://doi.org/10.1016/S0140-6736(15)00860-0Get rights and content

Abstract

Background

Many studies estimate the burden of perinatal depression, yet few have assessed continuing patterns of maternal depression in the initial years after childbirth. Since numerous child outcomes are related to perinatal depression, understanding ongoing childhood exposure has potentially important implications for families and clinical practice. We aimed to describe episodes of maternal depression during the first 5 years of children's lives in relation to the presence of maternal antenatal depression, postnatal depression, or both.

Methods

We used a population-based cohort of mother–child pairs from England who had linked primary care and hospital admission data from, respectively, the Clinical Practice Research Datalink and Hospital Episode Statistics for 1997–2014. Incidence of maternal depression was estimated per 100 person-years from 6 months after childbirth to the child's fifth birthday, stratified by whether the mother had antenatal depression, postnatal depression, or both. Incidence rate ratios (IRRs), adjusting for maternal age at delivery, socioeconomic status, and number of children aged 0–4 years in the household, were estimated with Poisson regression. Clinical diagnoses, antidepressant treatment, and admissions to hospital were used to identify episodes of depression. The study was approved by the Independent Scientific Advisory Committee for the Medicines and Healthcare products Regulatory Agency in February, 2014.

Findings

Of the 209 418 mothers in the cohort, 5091 (2·4%) had antenatal depression, 13 526 (6·5%) postnatal depression, and 6663 (3·2%) both. Incidence rates of maternal depression when the child was aged 6 months to 4 years were 22·5/100 person-years (95% CI 21·7–23·3) after antenatal depression, 16·0 (15·6–16·4) after postnatal depression, and 14·5 (14·0–15·1) after both, compared with 6·4 (6·3–6·5) for women without perinatal depression. After adjustment, depression rates remained more than twice as high among women with perinatal depression as those without (adjusted IRR 3·28 [3·16–3·39] after antenatal depression, 2·32 [2·26–2·39] after postnatal depression, and 2·18 [2·08–2·27] after both).

Interpretation

Women with perinatal depression have an increased risk of subsequent depressive episodes during the first 5 years of their child's life. Studies assessing perinatal depression as a risk factor for child outcomes need also to consider the effect of recurrent maternal depressive episodes occurring in the child's early years. This study only captured depressive episodes where medical attention was sought, and was unable to assess the effect of marital status and social support on risk of depression.

Funding

RB is funded by the National Institute for Health Research (NIHR) School for Primary Care Research and the University of Nottingham.

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