One-year trajectories of postpartum depressive symptoms and associated psychosocial factors: findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

[摘要] Background: Trajectories of postpartum depressive symptoms up to 1 year after childbirth and the related risk factors remain unclear. Accordingly, this study aimed to examine the 1-year trajectories of postpartum depressive symptoms and their associated risk factors. Methods: A total of 22,493 pregnant women were recruited between July 2013 and September 2016 in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Among them, 11,668 women with no missing data were included in the analyses. Depressive symptoms were assessed at 1 month and 1 year postpartum using the Edinburgh Postnatal Depression Scale. Multinominal logistic regression analysis was conducted after adjusting for covariates. Results: The prevalence of depression was 13.9% at 1 month and 12.9% at 1 year postpartum. We identified four depression trajectories, i.e., persistent (depressed throughout the 1 year postpartum) (6.0%), recovered (depressed at 1 month postpartum and recovered within a year) (7.9%), late-onset (became depressed after 1 month postpartum) (6.8%), and resilient (not depressed throughout 1 year postpartum) (79.2%). Psychological distress during pregnancy was significantly associated with all trajectories (persistent: odds ratio [OR]= 10.24, 95% confidence interval (CI)=8.40-12.48; recovered: OR=3.78, 95%CI=3.28-4.36; and late-onset: OR=3.96, 95%CI=3.40-4.62). Limitations: Postpartum depression was evaluated only by a self-administered questionnaire and the dropout rate was not neglectable. Conclusions: This study highlighted the high prevalence of depressive symptoms at 1 year postpartum and found that half of the depressive symptoms at 1 year were late-onset. The findings suggest the necessity of long-term follow-up (up to 1 year) for perinatal mental health.

[发布日期] 2021-12-01

[关键词] Postpartum depression;longitudinal study;risk factors;Tohoku Medical Megabank Project Birth and;Three-Generation Cohort Study