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Maternal depression more prevalent four years after birth

Posted: 21 May 2014 by Julie Griffiths

Depression in mothers is more common at four years after childbirth than at any time in the first 12 months, with mothers of one child most likely to suffer, according to new research.

Depressed girl 250x200
Credit: Shutterstock
A paper in the British Journal of Obstetrics and Gynaecology (BJOG) found that one in three women reported symptoms of depression at least once in the first four years after birth.

But the prevalence of depressive symptoms at four years after birth was higher than at any other time. 

And the study of 1507 women, who were recruited from six public hospitals in Melbourne, Australia, found that the women with one child at the four-year follow-up reported double the prevalence of depression compared with women with two or more children. 

The research showed that women with one child of four years old were most likely to have experienced relationship transitions, partner abuse and to have experienced a great number of stressful life events and social health issues in the preceding 12 months.

They were also more likely to have a low income and to have experienced depression in pregnancy and the first 12 months post-partum. 

At four years after birth, 40% of women who reported depressive symptoms had not previously reported feelings of depression.

The authors conclude that, based on these findings, the UK and Australia systems will miss more than half of women who experience depression in the early years of parenting. 

Women who have not had subsequent children are particularly vulnerable to going unnoticed because they miss out on the reconnections with health teams that occur during pregnancy.

The paper said that there was a need for the surveillance of maternal mental health to extend beyond the perinatal period with an expansion to focus on social health.

The authors pointed out that much attention is given to the surveillance of child and an increased focus on maternal health would be warranted given the strong connections between maternal and child health outcomes.

Commenting on the research, RCM professional policy advisor Janet Fyle said: 'Our recent report on maternal mental health highlighted the need for better identification and appropriate referral of women with mental health issues relating to the birth of a child. This research vindicates our position.
'Improvements need to be made in the detection of mental health problems in pregnancy and in the treatment and care afterwards. This research highlights that maternity services are failing women affected by mental health problems repeatedly and this leads to unnecessary suffering and distress for women and their families,' she said.

H Woolhouse, D Gartland, F Mensah, SJ Brown. (2014) Maternal depression from early pregnancy to four years postpartum in a prospective pregnancy cohort study: implications for primary care. BJOG