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Risk factors for antenatal depression, postnatal depression and parenting stress

Leigh B, Milgrom J - BMC Psychiatry (2008)

Bottom Line: Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression.Regression analyses identified significant risk factors for the three outcome measures. (1).These results provide clinical direction suggesting that early identification and treatment of perinatal depression is important.

Affiliation: Parent-Infant Research Institute, Department of Clinical and Health Psychology, Heidelberg Repatriation Hospital Austin Health, 300 Waterdale Rd, Heidelberg Heights 3081, Victoria, Australia. bronwyn.leigh@austin.org.au

ABSTRACT

Background: Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them.

Methods: Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI).

Results: Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors.

Conclusion: Risk factor profiles for antenatal depression, postnatal depression and parenting stress differ but are interrelated. Antenatal depression was the strongest predictor of postnatal depression, and in turn postnatal depression was the strongest predictor for parenting stress. These results provide clinical direction suggesting that early identification and treatment of perinatal depression is important.

A psychosocial model of antenatal depression, postnatal depression and parenting stress.
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Figure 1: A psychosocial model of antenatal depression, postnatal depression and parenting stress.

Mentions: In previous work, we conceptualised a biopsychosocial model of postnatal depression, which comprised vulnerability factors, precipitating factors, maintaining factors and considered there may be some mediating factors in the presentation of postnatal depression [29]. Here, we propose a broader contextual model of adjustment in pregnancy, birth and motherhood. We highlight the importance of antenatal stressors, personal resources and predisposing factors in the development and maintenance of antenatal depression and subsequent postnatal depression and parenting stress (Figure 1). The three outcome measures are embedded within the context. This model is an overall schematic representation of the results from this study and was not specifically tested. It does not take into account the relative weighting of each risk factor variable in relation to the three outcome measures.

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Risk factors for antenatal depression, postnatal depression and parenting stress

Leigh B, Milgrom J - BMC Psychiatry (2008)

A psychosocial model of antenatal depression, postnatal depression and parenting stress.
© Copyright Policy - open-access
Figure 1: A psychosocial model of antenatal depression, postnatal depression and parenting stress.
Mentions: In previous work, we conceptualised a biopsychosocial model of postnatal depression, which comprised vulnerability factors, precipitating factors, maintaining factors and considered there may be some mediating factors in the presentation of postnatal depression [29]. Here, we propose a broader contextual model of adjustment in pregnancy, birth and motherhood. We highlight the importance of antenatal stressors, personal resources and predisposing factors in the development and maintenance of antenatal depression and subsequent postnatal depression and parenting stress (Figure 1). The three outcome measures are embedded within the context. This model is an overall schematic representation of the results from this study and was not specifically tested. It does not take into account the relative weighting of each risk factor variable in relation to the three outcome measures.

Bottom Line: Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression.Regression analyses identified significant risk factors for the three outcome measures. (1).These results provide clinical direction suggesting that early identification and treatment of perinatal depression is important.

Affiliation: Parent-Infant Research Institute, Department of Clinical and Health Psychology, Heidelberg Repatriation Hospital Austin Health, 300 Waterdale Rd, Heidelberg Heights 3081, Victoria, Australia. bronwyn.leigh@austin.org.au

ABSTRACT

Background: Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them.

Methods: Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI).

Results: Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors.

Conclusion: Risk factor profiles for antenatal depression, postnatal depression and parenting stress differ but are interrelated. Antenatal depression was the strongest predictor of postnatal depression, and in turn postnatal depression was the strongest predictor for parenting stress. These results provide clinical direction suggesting that early identification and treatment of perinatal depression is important.

View Similar Images In: Results  - Collection
View Article: PubMed Central - HTML -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=2375874&rFormat=json&query=null&req=5