Shortening day length: a potential risk factor for perinatal depression
- 2.8k Downloads
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.
KeywordsDay 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.
- American College of Obstetricians and Gynecologists. (2011). Committee opinion #495: Vitamin D screening and supplementation during pregnancy. Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vitamin-D-Screening-and-Supplementation-During-Pregnancy. Accessed 4 April 2018
- 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 https://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy#vitamin. Accessed 4 April 2018
- American College of Obstetricians and Gynecologists. (2016). Committee opinion number 630: Screening for perinatal depression. Retrieved from https://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co630.pdf?dmc=1. Accessed 4 April 2018
- 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. https://doi.org/10.1210/jcem.83.1.4514 CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1023/A:1025132320321 CrossRefPubMedGoogle Scholar
- Cohen, J. (1988). Statistical power for the behavioral sciences (2nd ed.). New York: Lawrence Erlbaum Associates.Google Scholar
- 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. https://doi.org/10.1111/1471-0528.13111 CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1176/appi.ajp.162.4.656 CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1007/s00737-009-0070-9 CrossRefPubMedPubMedCentralGoogle Scholar
- 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. https://doi.org/10.1016/j.ejogrb.2014.05.017 CrossRefGoogle Scholar
- Lee, K. A., & DeJoseph, J. F. (1992). Sleep disturbances, vitality, and fatigue among a select group of employed childbearing women. Birth, 19, 208–213. https://doi.org/10.1111/j.1523-536X.1992.tb00404.x CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1016/j.jad.2017.12.106 CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1371/journal.pone.0122078 CrossRefPubMedPubMedCentralGoogle Scholar
- Mathews, T. J., & Hamilton, B. E. (2016). Mean age of mothers is on the rise: United States, 2000–2014. (232). National Center for Health Statistics, Division of Vital Statistics, Reproductive Statistics Branch Retrieved from https://www.cdc.gov/nchs/data/databriefs/db232.pdf. Accessed 4 April 2018
- 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. https://doi.org/10.4158/EP12072.OR CrossRefGoogle Scholar
- National Institutes of Health. (2016). Vitamin D fact sheet for health professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed 4 April 2018
- National Weather Service. (2017). The seasons, the equinox, and the solstices. Retrieved from http://www.weather.gov/cle/Seasons. Accessed 4 April 2018
- 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. https://doi.org/10.1176/appi.ajp.2008.08050709 CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1007/s00737-014-0422-y CrossRefGoogle Scholar
- 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
- 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. https://doi.org/10.1016/j.jpsychires.2015.04.021 CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1016/j.jogn.2017.08.002 CrossRefPubMedGoogle Scholar