Journal of Behavioral Medicine

, Volume 41, Issue 5, pp 690–702 | Cite as

Shortening day length: a potential risk factor for perinatal depression

  • Deepika GoyalEmail author
  • Caryl Gay
  • Rosamar Torres
  • Kathryn Lee


The aim of this secondary analysis was to determine whether seasonal light exposure, categorized by type of day length, is associated with or predictive of depressive symptoms in late pregnancy and the first 3 months postpartum. Women (n = 279) expecting their first child were recruited from prenatal clinics and childbirth education classes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Day lengths were categorized into short, lengthening, long and shortening. Data analysis included linear mixed models and multiple linear regression. When days were shortening (August to first 4 days of November) in late third trimester, depressive symptom scores were highest (35%) and continued to be higher at each postpartum assessment compared to other day length categories. Implications for clinical practice include increased vigilance for depressive symptoms, particularly if late pregnancy and birth occurs during the 3 months around the Autumn equinox when day length is shortening. Strategies that increase light exposure in late pregnancy and postpartum should also be considered.


Day length Season Autumn Winter Pregnancy Postpartum Depressive symptoms Sleep Actigraphy Mood 



Both randomized controlled trials reported in this paper were funded by: NIH/NINR Grant #: R01 NR45345.

Compliance with ethical standards

Conflict of interest

Deepika Goyal, Caryl Gay, Rosamar Torres, Kathryn Lee, declares that they have no conflict of interest.

Human and animal rights and Informed consent

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. Informed consent was obtained from all individual participants included in the study.


  1. American College of Obstetricians and Gynecologists. (2011). Committee opinion #495: Vitamin D screening and supplementation during pregnancy. Retrieved from Accessed 4 April 2018
  2. American College of Obstetricians and Gynecologists. (2015). Nutrition during pregnancy: Why is vitamin D important during pregnancy and how much do I need daily? Retrieved from Accessed 4 April 2018
  3. American College of Obstetricians and Gynecologists. (2016). Committee opinion number 630: Screening for perinatal depression. Retrieved from Accessed 4 April 2018
  4. Ancoli-Israel, S., Cole, R., Alessi, C., Chambers, M., Moorcroft, W., & Pollak, C. P. (2003). The role of actigraphy in the study of sleep and circadian rhythms. Sleep, 26, 342–392.CrossRefGoogle Scholar
  5. Awumey, E. M. K., Mitra, D. A., Hollis, B. W., Kumar, R., & Bell, N. H. (1998). Vitamin D metabolism is altered in Asian Indians in the southern United States: A clinical research center study. The Journal of Clinical Endocrinology and Metabolism, 83, 169–173. CrossRefPubMedGoogle Scholar
  6. Beeghly, M., Olson, K. L., Weinberg, M. K., Pierre, S. C., Downey, N., & Tronick, E. Z. (2003). Prevalence, stability, and socio-demographic correlates of depressive symptoms in Black mothers during the first 18 months postpartum. Maternal and Child Health Journal, 7, 157–168. CrossRefPubMedGoogle Scholar
  7. Burns, D. D., Sayers, S. L., & Moras, K. (1994). Intimate relationships and depression: Is there a causal connection? Journal of Consulting and Clinical Psychology, 62, 1033–1043.CrossRefGoogle Scholar
  8. Cohen, J. (1988). Statistical power for the behavioral sciences (2nd ed.). New York: Lawrence Erlbaum Associates.Google Scholar
  9. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.CrossRefGoogle Scholar
  10. Corral, M., Wardrop, A. A., Zhang, H., Grewal, A. K., & Patton, S. (2007). Morning light therapy for postpartum depression. Archives of Women’s Mental Health, 10, 221–224. CrossRefPubMedGoogle Scholar
  11. Crowley, S. K., & Youngstedt, S. D. (2012). Efficacy of light therapy for perinatal depression: A review. Journal of Physiolgical Anthropology, 31, 15. CrossRefGoogle Scholar
  12. Easterbrooks, M. A., Kotake, C., Raskin, M., & Bumgarner, E. (2016). Patterns of depression among adolescent mothers: Resilience related to father support and home visiting program. American Journal of Orthopscychiatry, 86, 61–68.CrossRefGoogle Scholar
  13. Fu, C. W., Liu, J. T., Tu, W. J., Yang, J. Q., & Cao, Y. (2015). Association between serum 25-hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression. British Journal of Obstetrics and Gynaecology, 122, 1688–1694. CrossRefPubMedGoogle Scholar
  14. Golden, R. N., Gaynes, B. N., Ekstrom, R. D., Hamer, R. M., Jacobsen, F. M., Suppes, T., et al. (2005). The efficacy of light therapy in the treatment of mood disorders: A review and meta-analysis of the evidence. American Journal of Psychiatry, 162, 656–662. CrossRefPubMedGoogle Scholar
  15. Goyal, D., Gay, C., & Lee, K. (2009). Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Archives of Women’s Mental Health, 12, 229–237. CrossRefPubMedPubMedCentralGoogle Scholar
  16. Goyal, D., Gay, C., & Lee, K. A. (2010). How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers? Womens Health Issues, 20, 96–104. CrossRefPubMedPubMedCentralGoogle Scholar
  17. Gur, E. B., Gokduman, A., Turan, G. A., Tatar, S., Hepyilmaz, I., Zengin, E. B., et al. (2014). Mid-pregnancy vitamin D levels and postpartum depression. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 179, 110–116. CrossRefGoogle Scholar
  18. Harris, S. S. (2006). Vitamin D and African Americans. The Journal of Nutrition, 136, 1126–1129.CrossRefGoogle Scholar
  19. Howard, L. M., Oram, S., Galley, H., Trevillion, K., & Feder, G. (2013). Domestic violence and perinatal mental disorders: A systematic review and meta-analysis. PLoS Medicine, 10, e1001452. CrossRefPubMedPubMedCentralGoogle Scholar
  20. Kettunen, P., & Hintikka, J. (2017). Psychosocial risk factors and treatment of new onset and recurrent depression during the post-partum period. Nordic Journal of Psychiatry, 71, 355–361. CrossRefPubMedGoogle Scholar
  21. Lee, K. A. (1992). Self-reported sleep disturbances in employed women. Sleep, 15, 493–498. CrossRefPubMedGoogle Scholar
  22. Lee, S. Y., Aycock, D. M., & Moloney, M. F. (2013). Bright light therapy to promote sleep in mothers of low-birth-weight infants: A pilot study. Biological Research for Nursing, 15, 398–406. CrossRefPubMedGoogle Scholar
  23. Lee, K. A., & DeJoseph, J. F. (1992). Sleep disturbances, vitality, and fatigue among a select group of employed childbearing women. Birth, 19, 208–213. CrossRefPubMedGoogle Scholar
  24. Lewy, A. J. (2007). Melatonin and human chronobiology. Cold Spring Harbor Symposia on Quantitative Biology, 72, 623–636. CrossRefPubMedGoogle Scholar
  25. Lyall, L. M., Wyse, C. A., Celis-Morales, C. A., Lyall, D. M., Cullen, B., Mackay, D., et al. (2018). Seasonality of depressive symptoms in women but not in men: A cross-sectional study in the UK Biobank cohort. Journal of Affective Disorders, 229, 296–305. CrossRefPubMedGoogle Scholar
  26. Marcus, S. M. (2009). Depression during pregnancy: Rates, risks and consequences—Motherisk update 2008. Canadian Journal of Clinical Pharmacology, 16, e15–e22.PubMedGoogle Scholar
  27. Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women’s Health (Larchmt), 12, 373–380. CrossRefGoogle Scholar
  28. Marqueze, E. C., Vasconcelos, S., Garefelt, J., Skene, D. J., Moreno, C. R., & Lowden, A. (2015). Natural light exposure, sleep and depression among day workers and shiftworkers at arctic and equatorial latitudes. PLoS ONE, 10, e0122078. CrossRefPubMedPubMedCentralGoogle Scholar
  29. Mathews, T. J., & Hamilton, B. E. (2016). Mean age of mothers is on the rise: United States, 20002014. (232). National Center for Health Statistics, Division of Vital Statistics, Reproductive Statistics Branch Retrieved from Accessed 4 April 2018
  30. Mitchell, D. M., Henao, M. P., Finkelstein, J. S., & Burnett-Bowie, S.-A. M. (2012). Prevalence and predictors of vitamin D deficiency in healthy adults. Endocrine practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 18, 914–923. CrossRefGoogle Scholar
  31. Muraca, G. M., & Joseph, K. S. (2014). The association between maternal age and depression. Journal of Obstetrics and Gynaecology Canada, 36, 803–810. CrossRefPubMedGoogle Scholar
  32. National Institutes of Health. (2016). Vitamin D fact sheet for health professionals. Retrieved from Accessed 4 April 2018
  33. National Weather Service. (2017). The seasons, the equinox, and the solstices. Retrieved from Accessed 4 April 2018
  34. Nussbaumer, B., Kaminski-Hartenthaler, A., Forneris, C. A., Morgan, L. C., Sonis, J. H., Gaynes, B. N., et al. (2015). Light therapy for preventing seasonal affective disorder. Cochrane Database Syst Rev. CrossRefPubMedGoogle Scholar
  35. Parry, B. L., Meliska, C. J., Sorenson, D. L., Lopez, A. M., Martinez, L. F., Nowakowski, S., et al. (2008). Plasma melatonin circadian rhythm disturbances during pregnancy and postpartum in depressed women and women with personal or family histories of depression. American Journal of Psychiatry, 165, 1551–1558. CrossRefPubMedGoogle Scholar
  36. Radloff, L. S. (1977). The ces-d scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. CrossRefGoogle Scholar
  37. Robinson, M., Whitehouse, A. J., Newnham, J. P., Gorman, S., Jacoby, P., Holt, B. J., et al. (2014). Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms. Archives of Women’s Mental Health, 17, 213–219. CrossRefGoogle Scholar
  38. Shaw, W., Dimsdale, J., & Patterson, T. (2000). Stress and life events measures. In A. J. Rush (Ed.), Handbook of psychiatric measures (1st ed., pp. 221–237). Washington, DC: American Psychiatric Association.Google Scholar
  39. Sit, D., Luther, J., Buysse, D., Dills, J. L., Eng, H., Okun, M., et al. (2015). Suicidal ideation in depressed postpartum women: Associations with childhood trauma, sleep disturbance and anxiety. Journal of Psychiatric Research, 66–67, 95–104. CrossRefPubMedGoogle Scholar
  40. Stremler, R., Sharkey, K., & Wolfson, A. (2017). Postpartum period and early motherhood. In M. Kryger, T. Roth, & W. C. Dement (Eds.), Principles and practice of sleep medicine (6th ed., pp. 1547–1552). Philadelphia, PA: Elsevier.CrossRefGoogle Scholar
  41. Torres, R., Goyal, D., Burke-Aaronson, A. C., Gay, C. L., & Lee, K. A. (2017). Patterns of symptoms of perinatal depression and stress in late adolescent and young adult mothers. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 46, 814–823. CrossRefPubMedGoogle Scholar
  42. Wang, E. J., Kripke, D. F., Stein, M. T., & Parry, B. L. (2003). Measurement of illumination exposure in postpartum women. BMC Psychiatry, 3, 5. CrossRefPubMedPubMedCentralGoogle Scholar
  43. Werner, E., Miller, M., Osborne, L. M., Kuzava, S., & Monk, C. (2015). Preventing postpartum depression: Review and recommendations. Archives of Women’s Mental Health, 18, 41–60. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Deepika Goyal
    • 1
    Email author
  • Caryl Gay
    • 2
  • Rosamar Torres
    • 3
  • Kathryn Lee
    • 2
  1. 1.The Valley Foundation School of NursingSan Jose State UniversitySan JoseUSA
  2. 2.Family Health Care NursingUniversity of San CaliforniaSan FranciscoUSA
  3. 3.UCLA School of NursingLos AngelesUSA

Personalised recommendations