Latent trajectory groups of perinatal depressive and anxiety symptoms from pregnancy to early postpartum and their antenatal risk factors
The aim of this study is to identify subgroups of women who exhibit distinct trajectory patterns of depressive and anxiety disorders from pregnancy to early postpartum and the risk factors associated with the latent trajectory group memberships. Women (n = 615) from the Feelings in Pregnancy and Motherhood (FIP) longitudinal study were followed from early pregnancy to early postpartum for a 7-month period in 2006–2007. The semi-parametric group-based trajectory modeling approach was used to identify the latent trajectory groups. Multinomial logit models were then used to explore the association between latent trajectory group membership and antenatal characteristics. We identified four latent trajectory groups of perinatal depressive symptoms: “low-stable” (49.6%), “moderate-stable” (42.3%), “postpartum” (3.6%), and “antepartum” (4.6%). Significant risk factors associated with these trajectory group memberships were past depression, stress level, ethnicity, the mother’s age, and relationship satisfaction. Three latent trajectory groups of perinatal anxiety symptoms were identified: “very low-stable” (8.9%); “low-stable” (60.7%); and “moderate-stable” (30.4%). Significant risk factor associated with these trajectories were past depression, stress level, and income level. Latent trajectory groups of perinatal depressive and anxiety symptoms were identified to uncover potential heterogeneity in populations. Our findings support the need for multiple assessments starting from early pregnancy to the postpartum, which can give some important insights on the characteristics of the women at high symptom burden trajectories for early interventions that may alter the progress of their mental symptoms.
KeywordsLongitudinal trajectories Group-based trajectory analysis Perinatal depression Perinatal anxiety Mood disorders
We thank the women who participated in the study. We also appreciate the funding support from the Canadian Institutes of Health Research (Grant No. IGP-77895). A. A. was partially support by a Natural Sciences and Engineering Research Council of Canada (NSERC) discovery grant held by C. F. and a scholarship from the Master of Public Health program, School of Public Health, the University of Saskatchewan.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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.
- Rahman K, Bowen A, Muhajarine N (2014) Examining the factors that moderate and mediate the effects on depression during pregnancy and postpartum. J Preg Child Health 1:116Google Scholar
- Goodman SH, Rouse MH. (2010) Perinatal Depression and Children: A Developmental Perspective. In: Tremblay RE, Boivin M, Peters RDeV, eds. Encyclopedia on Early Childhood Development [online]. http://www.child-encyclopedia.com/maternal-depression/according-experts/perinatal-depression-and-children-developmental-perspective. Accessed December 10, 2017.
- Vänskä M, Punamäki RL, Tolvanen A, Lindblom J, Flykt M, Unkila-Kallio L, Tiitinen A, Repokari L, Sinkkonen J, Tulppala M (2011) Maternal pre-and postnatal mental health trajectories and child mental health and development: prospective study in a normative and formerly infertile sample. Int J Behav Dev 35:517–531CrossRefGoogle Scholar
- WHO (2016) Maternal mental health. http://www.who.int/mental_health/maternal-child/maternal_mental_health/en/. Accessed 28 Apr 2017