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Cited by 116Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

Prediction of perinatal depression from adolescence and before conception (VIHCS): 20-year prospective cohort study

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Patton, George C, Romaniuk, Helena, Spry, Elizabeth, Coffey, Carolyn, Olsson, Craig, Doyle, Lex W, Oats, Jeremy, Hearps, Stephen +2 more·2015·The Lancet
DOI 10.1016/s0140-6736(14)62248-0
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Abstract

Background Perinatal depression is a neglected global health priority, affecting 10-15% of women in high-income countries and a greater proportion in low-income countries. Outcomes for children include cognitive, behavioural, and emotional difficulties and, in low-income settings, perinatal depression is associated with stunting and physical illness. In the Victorian Intergenerational Health Cohort Study (VIHCS), we aimed to assess the extent to which women with perinatal depressive symptoms had a history of mental health problems before conception.Methods VIHCS is a follow-up study of participants in the Victorian Adolescent Health Cohort Study (VAHCS), which was initiated in August, 1992, in the state of Victoria, Australia. In VAHCS, participants were assessed for health outcomes at nine timepoints (waves) from age 14 years to age 29 years. Depressive symptoms were measured with the Revised Clinical Interview Schedule and the General Health Questionnaire. Enrolment to VIHCS began in September, 2006, during the ninth wave of VAHCS; depressive symptoms at this timepoint were measured with the Composite International Diagnostic Interview. We contacted women every 6 months (from age 29 years to age 35 years) to identify any pregnancies. We assessed perinatal depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) by computer-assisted telephone interview at 32 weeks of gestation, 8 weeks after birth, and 12 months after birth. We defined perinatal depression as an EPDS score of 10 or more.Findings From a stratified random sample of 1000 female participants in VAHCS, we enrolled 384 women with 564 pregnancies. 253 (66%) of these women had a previous history of mental health problems at some point in adolescence or young adulthood. 117 women with a history of mental health problems in both adolescence and young adulthood had 168 pregnancies, and perinatal depressive symptoms were reported for 57 (34%) of these pregnancies, compared with 16 (8%) of 201 pregnancies in 131 women with no preconception history of mental health problems (adjusted odds ratio 8·36, 95% CI 3·34-20·87). Perinatal depressive symptoms were reported at one or more assessment points in 109 pregnancies; a preconception history of mental health problems was reported in 93 (85%) of these pregnancies.Interpretation Perinatal depressive symptoms are mostly preceded by mental health problems that begin before pregnancy, in adolescence or young adulthood. Women with a history of persisting common mental disorders before pregnancy are an identifiable high-risk group, deserving of clinical support throughout the childbearing years. Furthermore, the window for considering preventive intervention for perinatal depression should extend to the time before conception.Funding National Health and Medical Research Council (Australia), Victorian Health Promotion Foundation, Colonial Foundation, Australian Rotary Health Research and Perpetual Trustees.

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  • Emerging evidence points to origins as early as adolescence of both perinatal psychological distress and mother-infant bonding problems.

    “Emerging evidence points to origins as early as adolescence of both perinatal psychological distress and mother-infant bonding problems (Macdonald et al., 2018; Patton et al., 2015).”

    From Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis (2023) · cites this paper as Patton et al., 2015

  • A combination of strategies (anonymous screening, outreach, education, peer support, and emergency mental health care access) may be effective in reducing depression and high rates of suicide among physicians and nurses.

    “a combination of strategies (anonymous screening, outreach, education, peer support, and emergency mental health care access) may be effective in reducing depression and high rates of suicide among physicians and nurses. 395”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [395]

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Authors
Patton, G. C., Romaniuk, H., Spry, E., Coffey, C., Olsson, C., Doyle, L. W., Oats, J., Hearps, S., Carlin, J. B., & Brown, S.
Affiliations
  • Royal Children's Hospital (AU)
  • Deakin University (AU)
  • Royal Women's Hospital (AU)
  • The University of Melbourne (AU)
Corresponding author
Patton, George C
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2015-08
Volume
386
Issue
9996
Pages
875-883
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(14)62248-0
OpenAlex
W2120681435
Cited by
116
References
51
Citations by year
2026: 2 · 2025: 5 · 2024: 11 · 2023: 10 · 2022: 10 · 2021: 14 · 2020: 16 · 2019: 8 · 2018: 10 · 2017: 10 · 2016: 15 · 2015: 5
FWCI
14.27
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • Australian Rotary Health
  • State Government of Victoria
  • National Health and Medical Research Council
  • National Medical Research Council
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 › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
perinatal depression, adolescent mental health, young adult mental health, maternal depressive symptoms, pregnancy, risk factors, Edinburgh Postnatal Depression Scale, child outcomes, stunting, low-income settings, prospective cohort, maternal mental health screening, perinatal mental health services
MeSH terms
Adolescent, Mental Disorders, Depression, Depressive Disorder, Female, Follow-Up Studies, Humans, Parity, Pregnancy, Pregnancy Complications, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors, Victoria, Cohort Studies, Depression, Postpartum

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