Perinatal depressive symptoms often start in the prenatal rather than postpartum period: results from a longitudinal study
Open accessAbstract
Depressive symptoms during and after pregnancy confer risks for adverse outcomes in both the mother and child. Postpartum depression is traditionally diagnosed after birth of the child. Perinatal depression is a serious, prevalent heterogeneous syndrome that can occur during the period from conception through several months after childbirth. Onset and course are not well understood. There is a paucity of longitudinal studies of the disorder that include the antenatal period in population-based samples. We used an Internet panel of pregnant women recruited in 2 cohorts; 858 ascertained in the first and 322 ascertained in the third trimesters of pregnancy. We recruited the second cohort in order to assure sufficient sample to examine depressive symptoms later in pregnancy and in the postpartum period. Assessments included standard psychometric measures, health history, and pregnancy experience. The Edinburgh Postnatal Depression Scale was used for the assessment of depressive symptoms. Nearly 10% of women entered the pregnancy with depressive symptoms. Prevalence was about the same at 4 weeks and 3 months postpartum. During pregnancy, prevalence increased to 16% in the third trimester. Among incident cases, 80% occurred during pregnancy, with 1/3 occurring in the first trimester. We describe predictors of incident depressive symptoms and covariates associated with time-to-onset which include health history (psychiatric and medical) and social support covariates. The majority of incident depressive symptoms occur during pregnancy rather than afterward. This finding underscores the mandate for mental health screening early in pregnancy and throughout gestation. It will be important to find safe and effective interventions that prevent, mitigate, or delay the onset of depressive symptoms that can be implemented during pregnancy.
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Approximately 10% of women exhibit depressive symptoms in early pregnancy, with rates increasing over the course of pregnancy up to 16% in the third trimester.
“Approximately 10 % of women already exhibit depressive symptoms in early pregnancy, with rates increasing over the course of pregnancy up to 16 % in the third trimester (Wilcox et al., 2021).”
From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as Wilcox et al., 2021
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Self-citationReps, J. M., Wilcox, M., McGee, B. A., Leonte, M., LaCross, L., & Wildenhaus, K. J. (2022) · Figshare · doi:10.6084/m9.figshare.19906267
Self-citationReps, J. M., Wilcox, M., McGee, B. A., Leonte, M., LaCross, L., & Wildenhaus, K. J. (2022) · Figshare · doi:10.6084/m9.figshare.19906270
Self-citationReps, J. M., Wilcox, M., McGee, B. A., Leonte, M., LaCross, L., & Wildenhaus, K. J. (2022) · Figshare · doi:10.6084/m9.figshare.19906273
Self-citationReps, J. M., Wilcox, M., McGee, B. A., Leonte, M., LaCross, L., & Wildenhaus, K. J. (2022) · Figshare · doi:10.6084/m9.figshare.19906279
Self-citationPerspectives on perinatal depression and anxiety screening in primary care: a meta-synthesis
Pham, L., Collins, J. C., Moles, R. J., O’Reilly, C. L., & El‐Den, S. (2026) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2025.2609113
Rattaz, V., Offredi, V., & Horsch, A. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121510
Bartolini, E., Vozar, T. M., du Plessis, A., Andescavage, N. N., & Limperopoulos, C. (2026) · Maternal and Child Health Journal · doi:10.1007/s10995-026-04243-6
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Asadi, M., Noroozi, M., & Alavi, M. (2026) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-026-09095-0
Longitudinal analyses of depressive symptoms across pregnancy in Black women
Vaughan, S. E., Khalil, D., Hu, M., Hyer, S., Saadat, N., Misra, D. P., Kizza, F. N., & Giurgescu, C. (2026) · Annals of Epidemiology · doi:10.1016/j.annepidem.2026.110127
Cong, S., Xie, H., Zhu, R., Zhang, T., Han, J., Ni, S., Zhang, H., & Zhang, A. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122503
Gerhardt, B. C., dos Santos, M. E., Debastiani, V. B., Werner, E. A., Monk, C., & Arteche, A. X. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1943486
Revisiting Maternal Perinatal Depression: The Critical Role of Cultural ContextPreprint
Uriko, K. (2026) · Research Square · doi:10.21203/rs.3.rs-10751481/v1
Depression diagnoses and treatment during pregnancy among women enrolled in Medicaid
Ghose, S. S., Karakus, M., Welch, R., Rao, T., Lee, P., Ilie, C., Tucker, M., & Harris, A. (2026) · Current research in psychiatry · doi:10.46439/psychiatry.6.051
- Authors
- Wilcox, M., McGee, B. A., Ionescu, D. F., Leonte, M., LaCross, L., Reps, J., & Wildenhaus, K.
- Corresponding author
- Wilcox, Marsha
- Venue
- Archives of Women's Mental Health
- Published
- 2020-02-04
- Volume
- 24
- Issue
- 1
- Pages
- 119-131
- ISSN
- 1434-1816 (ISSN-L)
- 1435-1102
- PMC
- PMC7929945
- OpenAlex
- W3005408352
- Cited by
- 83
- References
- 25
- Citations by year
- 2026: 12 · 2025: 15 · 2024: 11 · 2023: 15 · 2022: 14 · 2021: 10 · 2020: 6
- FWCI
- 8.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Archives of Women s Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Janssen Research and Development (NA)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- perinatal depression, antenatal depression, postpartum depression, pregnancy, third trimester, first trimester, Edinburgh Postnatal Depression Scale, incident depression, predictors of depression, social support, maternal mental health
- MeSH terms
- Child, Depression, Female, Humans, Longitudinal Studies, Pregnancy, Pregnancy Complications, Psychiatric Status Rating Scales, Risk Factors, Depression, Postpartum, Parturition, Postpartum Period
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