Archives of Women's Mental Health

, Volume 22, Issue 1, pp 93–103 | Cite as

Postnatal depressive symptoms in women with and without antenatal depressive symptoms: results from a prospective cohort study

  • Despina PampakaEmail author
  • Stefania I. Papatheodorou
  • Mohammad AlSeaidan
  • Rihab Al Wotayan
  • Rosalind J. Wright
  • Julie E. Buring
  • Douglas W. Dockery
  • Costas A. Christophi
Original Article


Evidence exists that the risk factors for depression in the antenatal and postnatal period may differ, but only a handful of studies looked at depression longitudinally. The aims of this study were (1) to estimate the prevalence of postnatal depressive symptoms in Kuwait where data about postnatal depression are scarce and identify its determinants and (2) to compare these risk factors between women who had experienced antenatal depressive symptoms and those that did not. Data collected in the TRansgenerational Assessment of Children’s Environmental Risk (TRACER) Study in Kuwait were used in this analysis. The sample was restricted to the 1348 women who answered the Edinburgh Postnatal Depression Scale (EPDS) both antenatally and postnatally. The prevalence of postnatal depressive symptoms, defined by an EPDS score ≥ 10, was 11.7%. Overall, antenatal depressive symptoms were the strongest determinant of postnatal depressive symptoms. Multivariable logistic regression analysis showed that in women with depressive symptoms in pregnancy, having a lower household income was the most significant risk factor for postnatal depressive symptoms. Among women without antenatal depressive symptoms, those who had lower income, were Kuwaitis, experienced other problems in pregnancy such as perceived stress, PTSD symptoms and social isolation, and those who delivered a boy had higher odds of postnatal depressive symptoms. Antenatal depressive symptoms and other psychosocial characteristics can predict postnatal depressive symptoms. Therefore, maternal mental health issues should be detected during the antenatal period and support should be provided in order to lower the risk of postnatal depression and its sequelae.


Antenatal depressive symptoms Postnatal depressive symptoms Pregnancy Mental health Kuwait 



The TRACER study received funding from the Kuwait Foundation for the Advancement of Science and was supported by the Dasman Institute for Diabetes Research and the Kuwait Ministry of Health. We would also like to thank the administration and clinical staff at the South Hawalli Clinic, Al-Hakim Clinic, West Farwaniya Clinic, Subah Al Naser Clinic, Jahraa Clinic, Al-Sager Clinic, Al-Qurain Health Clinic, New Mowasat Hospital, and Royale Hayat Hospital. Most of all, we thank the participants of the TRACER study.


The TRACER study received funding from the Kuwait Foundation for the Advancement of Science.

Compliance with ethical standards

This is a secondary analysis of data collected in TRACER, a prospective birth cohort which received ethical approval from the institutional review boards of the Harvard T.H. Chan School of Public Health and the Dasman Diabetes Institute. A written consent from the woman and her partner was required before enrolment. The participating health centers, which included public hospitals in the six governorates of Kuwait and three private clinics, also gave permission for recruitment.

Conflicts of interest

All the authors wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Despina Pampaka
    • 1
    Email author
  • Stefania I. Papatheodorou
    • 1
  • Mohammad AlSeaidan
    • 2
  • Rihab Al Wotayan
    • 3
  • Rosalind J. Wright
    • 4
  • Julie E. Buring
    • 5
    • 6
  • Douglas W. Dockery
    • 6
    • 7
  • Costas A. Christophi
    • 1
    • 7
  1. 1.Cyprus International Institute for Environmental and Public HealthCyprus University of TechnologyLimassolCyprus
  2. 2.Dasman Diabetes InstituteKuwaitKuwait
  3. 3.Primary Health CareMinistry of HealthKuwaitKuwait
  4. 4.Department of Pediatrics and Institute for Exposomic ResearchIcahn School of Medicine at Mount SinaiNew YorkUSA
  5. 5.Division of Preventive Medicine, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  6. 6.Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonUSA
  7. 7.Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonUSA

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