Systematic Review of Prevalence of Antepartum Depression during the Trimesters of Pregnancy
Keywords:Pregnancy, Antepartum, Antenatal, Postpartum, Depression, Statistics, Correlation, Regression
BACKGROUND: Depression is prevalent during antenatal and postnatal stages of pregnancy. The effect of depression can be seen in complications during and after pregnancy, fetal growth retardation, abortions and preterm births. The literature abounds on postpartum depression (PD) while few studies are on antepartum depression (AD).
AIM: The systematic review aims to compute the prevalence of AD from published articles.
MATERIAL AND METHODS: The published articles (26) used in this review were obtained from the search of the search keywords â€œDepressive conditions in pregnancy AND trimestersâ€. All the articles were considered irrespective of language and their citation status as of the time of the query. Only articles that presented the prevalence mean and sample size were included. Articles on questionnaires filled by nonpregnant women and men were excluded. Articles that presented the prevalence of depression for the postpartum period only were excluded but were included if they addressed depression at both postpartum and trimester(s) of pregnancy. P-value of less than or equal to 0.05 was considered significant.
RESULTS: Analysis of the 26 articles showed that 4,303 subjects tested positive for depression in a sample of 28,248 pregnant mothers, giving the prevalence rate as 15%. Confounding was removed, and the sample size was adjusted to be 25,771 and 4,223 were screened to have depressive symptoms, thereby giving a new prevalence rate as 16.4%. It was also revealed that AD is most prevalent in the last trimester of pregnancy and least in the second trimester. Pregnancy duration and PD are not correlated with AD. This implies that AD can be observed in any period of the pregnancy and cannot predict the incidence of PD.
CONCLUSION: Efforts must be intensified to monitor pregnant women during the third trimester to reduce the incidence of maternal depression during pregnancy, thereby reducing the prevalence.
Plum Analytics Artifact Widget Block
Gawlik S, Reck C. Fatigue and depression during pregnancy. Background and therapeutic treatment. Psychotherapeutic. 2011; 56(3):224-230. https://doi.org/10.1007/s00278-011-0820-9
Eke AC, Saccone G, Berghella V. Selective serotonin reuptake inhibitor (SSRI) use during pregnancy and risk of preterm birth: a systematic review and meta-analysis. BJOG: An Int. J. Obst. Gynaecol. 2016; 123(12):1900-1907. https://doi.org/10.1111/1471-0528.14144
Spinelli MG, Endicott J, Leon AC, Goetz RR, Kalish RB, Brustman LE, Carmona YR, Meyreles Q, Vega M, Schulick JL. A controlled clinical treatment trial of interpersonal psychotherapy for depressed pregnant women at 3 New York city sites. J. Clin. Psychiatry. 2013; 74(4):393-399. https://doi.org/10.4088/JCP.12m07909
Shealy KM. Are antidepressants safe in the first trimester of pregnancy? J. Amer. Acad. Physic. Assist. 2015; 28(4):16-17. https://doi.org/10.1097/01.JAA.0000460911.55472.76
Spinelli MG, Endicott J, Goetz RR, Segre LS. Reanalysis of efficacy of interpersonal psychotherapy for antepartum depression versus parenting education program: Initial severity of depression as a predictor of treatment outcome. J. Clin. Psych. 2016; 77(4):535-540. https://doi.org/10.4088/JCP.15m09787
Bos SC, Macedo A, Marques M, Pereira AT, Maia BR, Soares MJ, Valente J, Gomes AA, Azevedo MH. Is positive affect in pregnancy protective of postpartum depression? Rev. Brasil. Psiqui. 2013; 35(1):5-12. https://doi.org/10.1016/j.rbp.2011.11.002
SylvÃ©n SM, Elenis E, Michelakos T, Larsson A, Olovsson M, Poromaa IS, Skalkidou A. Thyroid function tests at delivery and risk for postpartum depressive symptoms. Psychoneuroendocrinology. 2013; 38(7):1007-1013. https://doi.org/10.1016/j.psyneuen.2012.10.004
Lau Y, Htun TP, Kwong HKD. Sociodemographic, obstetric characteristics, antenatal morbidities, and perinatal depressive symptoms: A three-wave prospective study. PLoS ONE. 2018; 13(2):e0188365. https://doi.org/10.1371/journal.pone.0188365
Weisman O, Granat A, Gilboa-Schechtman E, Singer M, Gordon I, Azulay H, Kuint J, Feldman R. The experience of labor, maternal perception of the infant, and the mother's postpartum mood in a low-risk community cohort. Arch. Women Mental Health. 2010; 13(6):505-513. https://doi.org/10.1007/s00737-010-0169-z
DÃ¸rheim SK, Bondevik GT, Eberhard-Gran M, Bjorvatn B. Sleep and depression in postpartum women: A population-based study. Sleep. 2009; 32(7):847-855. https://doi.org/10.1093/sleep/32.7.847
Okun ML, Luther JF, Wisniewski SR, Wisner KL. Disturbed sleep and inflammatory cytokines in depressed and nondepressed pregnant women: An exploratory analysis of pregnancy outcomes. Psychosomatic Med. 2013; 75(7):670-681. https://doi.org/10.1097/PSY.0b013e31829cc3e7
Chang SR, Ho HN, Chen KH, Shyu MK, Huang LH, Lin WA. Depressive Symptoms as a Predictor of Sexual Function during Pregnancy. J Sex Medic. 2012; 9(10):2582-2589. https://doi.org/10.1111/j.1743-6109.2012.02874.x
Giurgescu C, Zenk SN, Templin TN, Engeland CG, Dancy BL, Park CG, Kavanaugh K, Dieber W, Misra DP. The Impact of Neighborhood Environment, Social Support, andAvoidance Coping on Depressive Symptoms of Pregnant African-American Women. Women's Health Issues. 2015; 25(3):294-302. https://doi.org/10.1016/j.whi.2015.02.001
Li T, Guo N, Jiang H, Eldadah M, Zhuang W. Social support and second trimester depression. Midwifery. 2019; 69:158-162. https://doi.org/10.1016/j.midw.2018.11.012
Steinig J, Nagl M, Linde K, Zietlow G, Kersting, A. Antenatal and postnatal depression in women with obesity: a systematic review. Arch. Women's Mental Health. 2017; 20(4):569-585. https://doi.org/10.1007/s00737-017-0739-4
Pedersen C, Leserman J, Garcia N, Stansbury M, Meltzer-Brody S, Johnson J. Late pregnancy thyroid-binding globulin predicts perinatal depression. Psychoneuroendocrinology. 2016; 65:84-93. https://doi.org/10.1016/j.psyneuen.2015.12.010
Gariepy AM, Lundsberg LS, Miller D, Stanwood NL, Yonkers KA. Are pregnancy planning and pregnancy timing associated with maternal psychiatric illness, psychological distress and support during pregnancy? J Affect Disorders. 2016; 205:87-94. https://doi.org/10.1016/j.jad.2016.06.058
SÃ©guin L, Potvin L, St.-Denis M, Loiselle J. Chronic stressors, social support, and depression during pregnancy. Obst Gynecol. 1995; 85(4):583-589. https://doi.org/10.1016/0029-7844(94)00449-N
Paarlberg KM, Vingerhoets AJJM, Passchier J, Heinen AGJJ, Dekker GA, Van Geijn HP. Psychosocial factors as predictors of maternal well-being and pregnancy-related complaints. J Psycho Obst Gynaecol. 1996; 17(2):93-102. https://doi.org/10.3109/01674829609025669
Costa R, Pacheco A, Figueiredo BA. Prevalence and predictors of depressive symptoms after childbirth. Rev Psiqui Clinica. 2007; 34(4):157-165. https://doi.org/10.1590/S0101-60832007000400001
Rahman A, Creed F. Outcome of prenatal depression and risk factors associated with persistence in the first postnatal year: Prospective study from Rawalpindi, Pakistan. J Affect Disorders. 2007; 100(1-3):115-121. https://doi.org/10.1016/j.jad.2006.10.004
Lee AM, Lam SK, Sze Mun Lau SM, Chong CSY, Chui HW, Fong DYT. Prevalence, course, and risk factors for antenatal anxiety and depression. Obst Gynecol. 2007; 110(5):1102-1112. https://doi.org/10.1097/01.AOG.0000287065.59491.70
Lara MA, Le HN, Letechipia G, Hochhausen L. Prenatal depression in Latinas in the U.S. and Mexico. Mater. Child Health. 2009; 13(4):567-576. https://doi.org/10.1007/s10995-008-0379-4
Christensen AL, Stuart EA, Perry DF, Le HN. Unintended Pregnancy and Perinatal Depression Trajectories in Low-Income, High-Risk Hispanic Immigrants. Prevent Sci. 2011; 12(3):289-299. https://doi.org/10.1007/s11121-011-0213-x
Le Strat Y, Dubertret C, Le Foll B. Prevalence and correlates of major depressive episode in pregnant and postpartum women in the United States. J Affect Disorders. 2011; 135(1-3):128-138. https://doi.org/10.1016/j.jad.2011.07.004
Melo Jr EF, Cecatti JG, Pacagnella RC, Leite DFB, Vulcani DE, Makuch MY. The prevalence of perinatal depression and its associated factors in two different settings in Brazil. J. Affect. Disorders. 2012; 136(3):1204-1208. https://doi.org/10.1016/j.jad.2011.11.023
Bindt C, Appiah-Poku J, Te Bonle M, Schoppen S, Feldt T, Barkmann C, Koffi M, Baum J, Nguah SB, Tagbor H, Guo N, N'Goran E, Ehrhardt S. Antepartum Depression and Anxiety Associated with Disability in African Women: Cross-Sectional Results from the CDS Study in Ghana and CÃ´te d'Ivoire. PLoS ONE. 2012; 7(10):e48396. https://doi.org/10.1371/journal.pone.0048396
Brunoni AR, Benute GRG, FrÃ¡guas R, Santos NO, Francisco RPV, De Lucia MCS, Zugaib MV. The self-rated Inventory of Depressive Symptomatology for screening prenatal depression. Int. J Gynecol Obst. 2013; 121(3):243-246. https://doi.org/10.1016/j.ijgo.2013.01.011
Coelho FMC, Pinheiro RT, Silva RA, Quevedo LÃ, Souza LDM, Castelli RD, de Matos MB, Pinheiro KAT. Major depressive disorder during teenage pregnancy: Socio-demographic, obstetric and psychosocial correlates. Rev Brasil Psiquia. 2013; 35(1):51-56. https://doi.org/10.1016/j.rbp.2012.03.006
Leung BMY, Kaplan BJ, Field CJ, Tough S, Eliasziw M, Gomez MF, McCargar LJ, Gagnon L, Dewey D, Bell RC, Bernier FP, Cantell M, Casey LM, Farmer A, Giesbrecht GF, Goonewardene L, Johnston DW, Kooistra L, Letourneau N, Manca DP, Martin JW, O'Beirne M, Pop VJ, Singhal N. Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort. BMC Preg Child. 2013; 13:2. https://doi.org/10.1186/1471-2393-13-2
BÃ¶decs T, SzilÃ¡gyi E, Cholnoky P, SÃ¡ndor J, Gonda X, Rihmer Z, HorvÃ¡th B. Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: Data from a Hungarian population-based sample. Psychiatria Danubina. 2013; 25(4):352-358.
Bittner A, Peukert J, Zimmermann C, Junge-Hoffmeister J, Parker LS, StÃ¶bel-Richter Y, Weidner K. Early intervention in pregnant women with elevated anxiety and depressive symptoms: Efficacy of a cognitive-behavioral group program. J Perinat Neonatal Nurs. 2014; 28(3):185-195. https://doi.org/10.1097/JPN.0000000000000027
Carolan-Olah M, Barry M. Antenatal stress: An Irish case study. Midwifery. 2014; 30(3):310-316. https://doi.org/10.1016/j.midw.2013.03.014
Ratcliff BG, Sharapova A, Suardi F, Borel F. Factors associated with antenatal depression and obstetric complications in immigrant women in Geneva. Midwifery. 2015; 31(9):871-878. https://doi.org/10.1016/j.midw.2015.04.010
Ferreira CR, Orsini MC, Vieira CR, do Amarante Paffaro A, Silva RR. Prevalence of anxiety symptoms and depression in the third gestational trimester. Arch Gynecol Obst. 2015; 291(5):999-1003. https://doi.org/10.1007/s00404-014-3508-x
Yang N, Gelaye B, Zhong Q, Rondon MB, Sanchez SE, Williams MA. Serum brain-derived neurotrophic factor (BDNF) concentrations in pregnant women with post-traumatic stress disorder and comorbid depression. Arch Women's Mental Health. 2016; 19(6):979-986. https://doi.org/10.1007/s00737-016-0638-0
Hinkle SN, Buck Louis GM, Rawal S, Zhu Y, Albert PS, Zhang C. A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period. Diabetologia. 2016; 59(12):2594-2602. https://doi.org/10.1007/s00125-016-4086-1
Di Venanzio C, Pacitti F, Rossetti MC, Santarelli V, Gregori E, D'Alfonso A, Carta G, Rossi A. Perinatal depression screening and early treatment. J Psychopathology. 2017; 23(3):99-104.
Tsai SY. Relationship of perceived job strain and workplace support to antenatal depressive symptoms among pregnant employees in Taiwan. Women and Health. 2019; 59(1):55-67. https://doi.org/10.1080/03630242.2018.1434590
Van Ravesteyn LM, Kamperman AM, Schneider TAJ, Raats ME, Steegers EAP, Tiemeier H, Hoogendijk WJG, Lambregtse-van den Berg MP. Group-based multicomponent treatment to reduce depressive symptoms in women with co-morbid psychiatric and psychosocial problems during pregnancy: A randomized controlled trial. J Affect Disorders. 2018; 226:36-44. https://doi.org/10.1016/j.jad.2017.09.019
Zvorsky I, Skelly JM, Higgins ST. Effects of financial incentives for smoking cessation on mood and anxiety symptoms among pregnant and newly postpartum women. Nicot Tobacco Res. 2018; 20(5):620-627. https://doi.org/10.1093/ntr/ntx111
Vergel J, Gaviria SL, Duque M, Restrepo D, Rondon M, Colonia A. Gestation-related psychosocial factors in women from Medellin, Colombia. Rev Colomb Psiqui. 2019; 48(1):26-34. https://doi.org/10.1016/j.rcp.2017.06.003
Alves SE, Fonseca A, Canavarro MC, Pereira M. Predictive validity of the Postpartum Depression Predictors Inventory-Revised (PDPI-R): A longitudinal study with Portuguese women. Midwifery. 2019; 69:113-120. https://doi.org/10.1016/j.midw.2018.11.006
Oguntunde PE, Adejumo AO, Okagbue HI. Breast Cancer Patients in Nigeria: Data exploration approach. Data in Brief. 2017; 15:47-57. https://doi.org/10.1016/j.dib.2017.08.038
Adamu PI, Oguntunde PE, Okagbue HI, Agboola OO. Statistical data analysis of cancer incidences in insurgency affected states in Nigeria. Data in Brief. 2018; 18:2029-2046. https://doi.org/10.1016/j.dib.2018.04.135
Adejumo AO, Ikoba NA, Suleiman EA, Okagbue HI, Oguntunde PE, Odetunmibi OA, Job O. Quantitative Exploration of Factors influencing Psychotic Disorder Ailments in Nigeria. Data in Brief. 2017; 14:175-85. https://doi.org/10.1016/j.dib.2017.07.046
Adamu PI, Adamu MO, Okagbue HI. Data in support of high rate of pregnancy related deaths in Maiduguri, Borno State, Northeast Nigeria. Data in Brief. 2018; 18:409-414. https://doi.org/10.1016/j.dib.2018.03.038
Adejumo AO, Suleiman EA, Okagbue HI, Oguntunde PE, Odetunmibi OA. Quantitative Evaluation of Pregnant Women Delivery Status' Records in Akure, Nigeria. Data in Brief. 2018; 16:127-34. https://doi.org/10.1016/j.dib.2017.11.041
Adamu PI, Oguntunde PE, Okagbue HI, Agboola OO. On the Epidemiology and Statistical Analysis of HIV/AIDS Patients in the Insurgency Affected States of Nigeria. Open Access Maced J Med Sci. 2018; 6 (7):1315-1321. https://doi.org/10.3889/oamjms.2018.229
How to Cite
Copyright (c) 2019 Hilary I. Okagbue, Patience I. Adamu, Sheila A. Bishop, Pelumi E. Oguntunde, Abiodun A. Opanuga, Elvir M. Akhmetshin
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All rights reserved.