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Heterogeneity in perinatal depression: how far have we come? A systematic review
Open accessAbstract
Despite perinatal depression (PND) being a common mental disorder affecting pregnant women and new mothers, limited attention has been paid to the heterogeneous nature of this disorder. We examined heterogeneity in PND symptom profiles and symptom trajectories. Literature searches revealed 247 studies, 23 of which were included in the final review. The most common statistical approaches used to explore symptom and trajectory heterogeneity were latent class model and growth mixture model. All but one study examined PND symptom trajectories and provided collective evidence of at least three heterogeneous patterns: low, medium, or chronic-high symptom levels. Social and psychological risk factors were the most common group of predictors related to a higher burden (high sum of score) of depressive symptoms. These studies were consistent in reporting poorer health outcomes for children of mothers assigned to high burden symptom trajectories. Only one study explored heterogeneity in symptom profile and was the only one to describe the specific constellations of depressive symptoms related to the PND heterogeneous patterns identified. Therefore, there is limited evidence on the specific symptoms and symptom configurations that make up PND heterogeneity. We suggest directions for future research to further clarify the PND heterogeneity and its related mechanisms.
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“Finally, contextual factors related to the intimate relationship, namely poorer relationship quality and lack of social support, have been linked to maternal depression and anxiety [13, 15, 40], as well as paternal depression [32, 34, 42].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [13]
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“a history of psychiatric problems (e.g., depression) has consistently been identified as a predictor of maternal perinatal depression and anxiety [13, 15, 37, 38, 40], as well as paternal postpartum depression [34].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [13]
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“Finally, contextual factors related to the intimate relationship, namely poorer relationship quality and lack of social support, have been linked to maternal depression and anxiety [13, 15, 40], as well as paternal depression [32, 34, 42].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [13]
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Kingston, D. E., Kehler, H. L., Austin, M., Mughal, M. K., Wajid, A., Vermeyden, L., Benzies, K., Brown, S., Stuart, S. P., & Giallo, R. (2018) · PLoS ONE · doi:10.1371/journal.pone.0195365 · Cited by 224
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Kiviruusu, O., Pietikäinen, J. T., Kylliäinen, A., Pölkki, P., Saarenpää-Heikkilä, O., Marttunen, M., Paunio, T., & Paavonen, E. J. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.09.038 · Cited by 143
Characteristics of women with different perinatal depression trajectories
Wikman, A., Axfors, C., Iliadis, S. I., Cox, J., Fransson, E., & Skalkidou, A. (2019) · Journal of Neuroscience Research · doi:10.1002/jnr.24390 · Cited by 118
Junior, H. P. D. O. S., Fried, E. I., Asafu-Adjei, J. K., & Ruiz, R. J. (2017) · Research in Nursing & Health · doi:10.1002/nur.21784 · Cited by 124
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Metadata
- Authors
- Santos, H., Tan, X., & Salomon, R.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Archives of Women's Mental Health
- Published
- 2016-10-29
- Volume
- 20
- Issue
- 1
- Pages
- 11-23
- ISSN
- 1434-1816 (ISSN-L)
- 1435-1102
- PMC
- PMC5507213
- OpenAlex
- W2545237038
- Cited by
- 133
- References
- 56
- Citations by year
- 2026: 14 · 2025: 5 · 2024: 14 · 2023: 30 · 2022: 20 · 2021: 15 · 2020: 11 · 2019: 13 · 2018: 5 · 2017: 6
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Archives of Women s Mental Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- OSF Preprints (OSF Preprints) (submittedVersion)
- Funders
- NIH Clinical and Translational Science Award (550KR131619)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- perinatal depression, heterogeneity, symptom trajectories, symptom profiles, latent class models, growth mixture modeling, risk factors, maternal mental health, child health outcomes, chronic depression
- MeSH terms
- Adult, Depression, Female, Humans, Mothers, Pregnancy, Pregnancy Complications, Puerperal Disorders
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