Original Paper

Social Psychiatry and Psychiatric Epidemiology

, Volume 49, Issue 5, pp 711-721

Antenatal maternal mental health as determinant of postpartum depression in a population based mother–child cohort (Rhea Study) in Crete, Greece

  • Katerina KoutraAffiliated withDepartment of Social Medicine, Faculty of Medicine, University of CreteDepartment of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete Email author 
  • , Maria VassilakiAffiliated withDepartment of Social Medicine, Faculty of Medicine, University of Crete
  • , Vaggelis GeorgiouAffiliated withDepartment of Social Medicine, Faculty of Medicine, University of Crete
  • , Antonios KoutisAffiliated withDepartment of Social Medicine, Faculty of Medicine, University of Crete
  • , Panos BitsiosAffiliated withDepartment of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete
  • , Leda ChatziAffiliated withDepartment of Social Medicine, Faculty of Medicine, University of Crete
  • , Manolis KogevinasAffiliated withNational School of Public HealthCentre for Research in Environmental Epidemiology (CREAL)Municipal Institute of Medical ResearchCIBER Epidemiologia y Salud Pública (CIBERESP)

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Abstract

Purpose

Antenatal maternal mental health has been identified as an important determinant of postpartum depression (PPD). We investigated the occurrence of depression both antenatally and postnatally and examined whether maternal trait anxiety and depression during pregnancy were associated with PPD at 8 weeks postpartum in a prospective mother–child cohort (Rhea Study) in Crete, Greece.

Methods

438 women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Trait subscale of the State-Trait Anxiety Inventory (STAI-Trait) questionnaires assessing antenatal depression and anxiety, respectively, during the third trimester of pregnancy as well as the EPDS at 8 weeks postpartum.

Results

The prevalence of women with probable depression (EPDS score ≥13) was 16.7 % at 28–32 weeks of pregnancy and 13.0 % at 8 weeks postpartum. A per 5 unit increase in the STAI-Trait subscale increased the odds for PPD by 70 % (OR = 1.70, 95 % CI 1.41, 2.05), whereas a per unit increase in EPDS during pregnancy increased the odds for PPD by 27 % (OR = 1.27, 95 % CI 1.19, 1.36).

Conclusions

Our findings suggest that antenatal maternal psychological well-being has a significant effect on PPD, which might have important implications for early detection during pregnancy of women at risk for postpartum depression.

Keywords

Antenatal anxiety Antenatal depression Postpartum depression