Cited by 329Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcarePregnancy-related medical research

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Depressive Disorders During Pregnancy: Prevalence and Risk Factors in a Large Urban Sample

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Melville, Jennifer L., Gavin, Amelia, Guo, Yuqing, Fan, Ming-Yu, Katon, Wayne J.·2010·Obstetrics & Gynecology

DOI 10.1097/aog.0b013e3181f60b0aPMC PMC3068619

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Abstract

OBJECTIVE: To estimate the prevalence of major and minor depression, panic disorder, and suicidal ideation during pregnancy while also identifying factors independently associated with antenatal depressive disorders. METHODS: In this prospective study, participants were 1,888 women receiving ongoing prenatal care at a university obstetric clinic from January 2004 through January 2009. Prevalence of psychiatric disorders was measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria based on the Patient Health Questionnaire. Multiple logistic regression identified factors associated with probable major depressive disorder and any depressive disorder. RESULTS: Antenatal depressive disorders were present in 9.9% with 5.1% (97) meeting criteria for probable major depression and 4.8% (90) meeting criteria for probable minor depression. Panic disorder was present in 3.2% (61), and current suicidal ideation was reported by 2.6% (49). Among patients with probable major depression, 29.5% (28) reported current suicidal ideation. Psychosocial stress (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.21-1.36), domestic violence (OR 3.45; 95% CI 1.46-8.12), chronic medical conditions (OR 3.05; 95% CI 1.63-5.69), and race (Asian: OR 5.81; 95% CI 2.55-13.23; or African American: OR 2.98; 95% CI 1.24-7.18) each significantly increased the odds of probable antepartum major depressive disorder, whereas older age (OR 0.92; 95% CI 0.88-0.97) decreased the odds. Factors associated with odds of any depression were similar overall except that Hispanic ethnicity (OR 2.50; 95% CI 1.09-5.72) also independently increased the odds of any depression. CONCLUSION: Antenatal major and minor depressive disorders are common and significantly associated with clinically relevant and identifiable risk factors. By understanding the high point prevalence and associated factors, clinicians can potentially improve the diagnosis and treatment rates of serious depressive disorders in pregnant women. LEVEL OF EVIDENCE: II.

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“There is a significant correlation (r ¼ .59) between the EPDS and the structured clinical interview for DSM-IV [24].”
Method
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“, SCID or DIS) (Melville et al., 2010; Tandon et al., 2012; Davis et al., 2013; Pitanupong et al., 2007) the present study combined two depression screening tools to administer an antenatal sample of Chinese pregnant women with obstetric complications to determine the efficacy without comparison with any diagnostic (e.”
Method
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“Chronic health problems put women at significantly greater risk of perinatal depression (Melville et al. 2011).”
Background
Chronic Maternal Depression Is Associated with Reduced Weight Gain in Latino Infants from Birth to 2 Years of Age
Wojcicki, J. M., Holbrook, K. E., Lustig, R. H., Epel, E. S., Caughey, A. B., Muñoz, R. F., Shiboski, S. C., & Heyman, M. B. (2011) · PLoS ONE · doi:10.1371/journal.pone.0016737 · Cited by 66
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“However, discrepant findings have been reported by previous studies [8,12,27,31,32,36,38,40,43, 44].”
Result
Is antenatal depression associated with adverse obstetric and perinatal outcomes?
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“hypertension [4] as more prevalent among women suffering from depression in comparison to control groups.”
Background
Co-Occurring Intimate Partner Violence and Mental Health Diagnoses in Perinatal Women
Cerulli, C., Talbot, N. L., Tang, W., & Chaudron, L. H. (2011) · Journal of Women s Health · doi:10.1089/jwh.2010.2201 · Cited by 74
“44 Well-baby visits may be an opportunity not only to identify women and children at risk, but also to intervene.”
Lower inflammatory markers in women with antenatal depression brings the M1/M2 balance into focus from a new direction
Edvinsson, Å., Bränn, E., Hellgren, C., Freyhult, E., White, R. A., Kamali‐Moghaddam, M., Olivier, J., Bergquist, J., Boström, A. E. D., Schiöth, H. B., et al. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.02.027 · Cited by 62
The Relationship Between Gestational Diabetes and Antenatal Depression
Byrn, M., & Penckofer, S. (2015) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/1552-6909.12554 · Cited by 80
Microbiota of newborn meconium is associated with maternal anxiety experienced during pregnancy
Hu, J., Ly, J. J., Zhang, W., Huang, Y., Glover, V. A. S., Peter, I., Hurd, Y. L., & Nomura, Y. (2019) · Developmental Psychobiology · doi:10.1002/dev.21837 · Cited by 59
Postpartum Perceived Stress Explains the Association between Perceived Social Support and Depressive Symptoms
Leonard, K. S., Evans, M. B., Kjerulff, K. H., & Downs, D. S. (2020) · Women s Health Issues · doi:10.1016/j.whi.2020.05.001 · Cited by 60
New parents’ experiences of postpartum depression: a systematic review of qualitative evidence
Holopainen, A., & Hakulinen, T. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003909 · Cited by 81
The Broken Thread of Health Promotion and Disease Prevention for Women During the Postpartum Period
Walker, L. O., Murphey, C. L., & Nichols, F. H. (2015) · The Journal of Perinatal Education · doi:10.1891/1058-1243.24.2.81 · Cited by 59
“Over the past 20 years in the United States, the incidence of preeclampsia has increased by 25% (American College of Obstetricians and Gynecologists [ACOG], 2013a; Wallis, Saflas, Hsia, & Atrash, 2008).”
BackgroundInfluential
Chronic Medical Conditions and Peripartum Mental Illness: A Systematic Review and Meta-Analysis
Brown, H. K., Qazilbash, A., Rahim, N., Dennis, C., & Vigod, S. N. (2018) · American Journal of Epidemiology · doi:10.1093/aje/kwy080 · Cited by 56
Effects of maternal stress and nutrient restriction during gestation on offspring neuroanatomy in humans
Franke, K., den Bergh, B. R. H. V., de Rooij, S. R., Kroegel, N., Nathanielsz, P. W., Rakers, F., Roseboom, T. J., Witte, O. W., & Schwab, M. G. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.01.031 · Cited by 52
“Depressive disorders during pregnancy are present in about 10% of women, with about 5% meeting criteria for probable major depression (Melville et al., 2010).”
Background
Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study
Pugh, N. E., Hadjistavropoulos, H. D., Hampton, A. J. D., Bowen, A., & Williams, J. L. (2014) · Archives of Women s Mental Health · doi:10.1007/s00737-014-0449-0 · Cited by 50
“Approximately 8 to 15 % of women are afflicted with postpartum depression (PPD) following childbirth (Chalmers et al. 2008; Melville et al. 2010).”
BackgroundInfluential
Treatment of Substance Use Disorders Among Women of Reproductive Age by Depression and Anxiety Disorder Status, 2008–2014
Zhou, J., Ko, J. Y., Haight, S. C., & Tong, V. T. (2019) · Journal of Women s Health · doi:10.1089/jwh.2018.7597 · Cited by 52
Use of selective serotonin reuptake inhibitors (SSRIs) in women delivering liveborn infants and other women of child-bearing age within the U.S. Food and Drug Administration’s Mini-Sentinel program
Andrade, S. E., Reichman, M. E., Mott, K., Pitts, M., Kieswetter, C., Dinatale, M., Stone, M. B., Popovic, J., Haffenreffer, K., & Toh, S. (2016) · Archives of Women's Mental Health · doi:10.1007/s00737-016-0637-1 · Cited by 50
“An estimated 10 % of women or more experience depression during pregnancy (Bennett et al. 2004; Gavin et al. 2005; Melville et al. 2010; Le Strat et al. 2011).”
Background
Subjecting Dams to Early Life Stress and Perinatal Fluoxetine Treatment Differentially Alters Social Behavior in Young and Adult Rat Offspring
Houwing, D. J., Staal, L., Swart, J. M., Ramsteijn, A. S., Wöhr, M., de Boer, S. F., & Olivier, J. D. A. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.00229 · Cited by 50
“More important, up to 5% of pregnant women suffer from major depression and cannot function normally without antidepressant treatment (Gaynes et al., 2005; Melville et al., 2010).”
Background
The Prevalence and Correlates of Depressive Symptoms Among Adolescent Mothers: Results from a 17-Year Longitudinal Study
Gavin, A. R., Lindhorst, T. P., & Lohr, M. J. (2011) · Women & Health · doi:10.1080/03630242.2011.606355 · Cited by 47
“The population most at risk for depressive disorders is women of childbearing age because the onset of depression is often intertwined with reproductive events (Melville et al., 2010).”
Background
Predictors and Changes in Paternal Perinatal Depression Profiles—Insights From the DREAM Study
Garthus-Niegel, S., Staudt, A., Kinser, P., Haga, S. M., Drozd, F., & Baumann, S. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.563761 · Cited by 46
“Given the clear need for longitudinal studies on paternal perinatal depression, this population-based study aimed to (1) estimate prevalence rates of perinatal depression symptoms among German (expectant) fathers, (2) identify differential profiles of perinatal depression in (expectant) fathers, (3) determinemodifiabl…”
Background
The mediating role of coping styles in the relationship between perceived social support and antenatal depression among pregnant women: a cross-sectional study
Chen, Z., Li, Y., Chen, J., & Guo, X. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04377-9 · Cited by 46
A population survey of prevalence rates of antenatal depression in the Irish obstetric services using the Edinburgh Postnatal Depression Scale (EPDS)
Jairaj, C., Fitzsimons, C. M., McAuliffe, F. M., O’Leary, N., Joyce, N., McCarthy, A., Cassidy, E., Donnelly, J. C., Tully, E. C., Imcha, M., et al. (2018) · Archives of Women s Mental Health · doi:10.1007/s00737-018-0893-3 · Cited by 51
Poor marital support associate with anxiety and worries during pregnancy in Greek pregnant women
Gourounti, K., Anagnostopoulos, F., & Sandall, J. (2013) · Midwifery · doi:10.1016/j.midw.2013.10.008 · Cited by 47
“5% (Lee et al., 2007; Leigh and Milgrom, 2008; Bodecs et al., 2009; Qiao et al., 2009; Teixeira et al., 2009; Kaaya et al., 2010; Melville et al., 2010; Mohammad et al., 2011; Nasreen et al., 2011; FaisalCury et al., 2012; Gourounti et al., 2013a; Carolan-Olah and Barry, 2013) and the incidence rate of antenatal anxie…”
BackgroundInfluential
Racial and ethnic disparities in pregnancy complications and the protective role of greenspace: A retrospective birth cohort study
Runkle, J. D., Matthews, J. L., Sparks, L., McNicholas, L., & Sugg, M. M. (2021) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2021.152145 · Cited by 47
A cross-sectional study of depression among women attending antenatal clinics in Blantyre district, Malawi
Chorwe‐Sungani, G., & Chipps, J. A. (2018) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v24i0.1181 · Cited by 43
Maternal Distress during Pregnancy and the Postpartum Period: Underlying Mechanisms and Child’s Developmental Outcomes—A Narrative Review
Jeličić, L., Veselinović, A., Ćirović, M., Jakovljevic, V. L., Raičević, S., & Subotić, M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232213932 · Cited by 54
“5% [32], while 10–20% of pregnant women experience psychosocial stress and depressive disorders [33,34].”
Background
Mediators of Adverse Birth Outcomes Among Socially Disadvantaged Women
Gavin, A. R., Nurius, P. S., & Logan‐Greene, P. (2011) · Journal of Women s Health · doi:10.1089/jwh.2011.2766 · Cited by 48
“Further, maternal depression, a condition related to stress, is prevalent among women of childbearing age because the onset of depression is often intertwined with reproductive events.(37) There is evidence that antenatal depression is linked to negative birth outcomes.”
Background
A case–control study of sporadic retinoblastoma in relation to maternal health conditions and reproductive factors: a report from the Children’s Oncology group
Heck, J. E., Omidakhsh, N., Azary, S., Ritz, B. R., Ehrenstein, O. S. V., Bunin, G. R., & Ganguly, A. A. (2015) · BMC Cancer · doi:10.1186/s12885-015-1773-0 · Cited by 43
“In contrast, the prevalence of depression was much lower in our study than has been seen in other US surveys (10–12 % [54, 55]), potentially due to parental reluctance to disclose mental health problems to interviewers.”
Result
Views and Experiences of Suicidal Ideation During Pregnancy and the Postpartum: Findings from Interviews with Maternal Care Clinic Patients
Tabb, K. M., Gavin, A. R., Guo, Y., Huang, H. Y., Debiec, K. E., & Katon, W. J. (2013) · Women & Health · doi:10.1080/03630242.2013.804024 · Cited by 42
“The longitudinal study protocol has been described in detail elsewhere (Bentley et al., 2007; Melville et al., 2010).”
Potential for a Stress Reduction Intervention to Promote Healthy Gestational Weight Gain: Focus Groups with Low-Income Pregnant Women
Thomas, M., Vieten, C., Adler, N. E., Ammondson, I., Coleman‐Phox, K., Epel, E. S., & Laraia, B. A. (2014) · Women s Health Issues · doi:10.1016/j.whi.2014.02.004 · Cited by 42
The combination of fluoxetine and environmental enrichment reduces postpartum stress-related behaviors through the oxytocinergic system and HPA axis in mice
Bashiri, H., Houwing, D. J., Homberg, J. R., & Salari, A. (2021) · Scientific Reports · doi:10.1038/s41598-021-87800-z · Cited by 41
Does Maternal Mental Well-Being in Pregnancy Impact The Early Human Epigenome?
Ryan, J., Mansell, T., Fransquet, P., & Saffery, R. (2017) · Epigenomics · doi:10.2217/epi-2016-0118 · Cited by 46
The Contribution of Untreated and Treated Anxiety and Depression to Prenatal, Intrapartum, and Neonatal Outcomes
Ogunyemi, D. A., Jovanovski, A. P., Liu, J., Friedman, P., Sugiyama, N., Creps, J. R., & Madan, I. (2018) · American Journal of Perinatology Reports · doi:10.1055/s-0038-1661379 · Cited by 41
Life Cycle and Suicidal Behavior among Women
Méndez-Bustos, P., López‐Castromán, J., Baca‐García, E., & Ceverino, A. (2013) · The Scientific World JOURNAL · doi:10.1155/2013/485851 · Cited by 42
“Between 10–25% of pregnant and postpartum women experience depressive disorders [63, 64] or anxiety disorders [65, 66].”
Background
Assessment of Burden of Depression During Pregnancy Among Pregnant Women Residing in Rural Setting of Chennai
Srinivasan, N. (2015) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2015/12380.5850 · Cited by 41
“These have resulted in immediate effects including low birth weight, intra uterine growth restriction and preterm birth to long term implications like malnutrition, inadequate child growth, and impaired behavioural, emotional and cognitive abilities and poor mental health in future [1,11-13].”
Background
Predictors of emotional distress in pregnant women: the mediating role of relationship intimacy
Costa, E. C. V., Castanheira, E., Moreira, L., Correia, P., Ribeiro, D., & Pereira, M. G. (2017) · Journal of Mental Health · doi:10.1080/09638237.2017.1417545 · Cited by 39
“In addition, we confirmed the result of previous studies that young economically disadvantaged women with a history of miscarriage tend to experience more emotional problems during pregnancy (Gourounti et al., 2013; Melville et al., 2010).”
BackgroundResultInfluential
Management of perinatal depression with non-drug interventions
Johansen, S. L., Robakis, T. K., Williams, K. E., & Rasgon, N. (2019) · BMJ · doi:10.1136/bmj.l322 · Cited by 41
Review of suicidal ideation during pregnancy: risk factors, prevalence, assessment instruments and consequences
Legazpi, P. C. C., Muñoz, M. D. L. F. R., Crespo, M. E. O., & Méndez, N. I. (2022) · Psicologia Reflexão e Crítica · doi:10.1186/s41155-022-00220-4 · Cited by 47
“During pregnancy, the prevalence of suicidal ideation varies amongst studies from 2.6 to 29.2% (Copersino et al., 2008; Gavin et al., 2011; Lindahl et al., 2005; Melville et al., 2010; Newport et al., 2007).”
BackgroundInfluential
Obstetric and psychosocial risk factors for depressive symptoms during pregnancy
Dudas, R. B., Csatordai, S., Devosa, I., Töreki, A., Andó, B., Barabás, K. N., Pál, A., & Kozinszky, Z. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.04.017 · Cited by 37
“Our study has provided further evidence that perceived support from the family environment can help the mother (Pajulo et al., 2001; Lancaster et al., 2010; Melville et al., 2010).”
BackgroundInfluential
Patterns of intimate partner violence among perinatal women with depression symptoms in Khayelitsha, South Africa: a longitudinal analysis
Schneider, M., Baron, E., Davies, T., Munodawafa, M., & Lund, C. (2018) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2018.1 · Cited by 35
A Socioecological Framework to Assessing Depression Among Pregnant Teens
Buzi, R. S., Smith, P. B., Kozinetz, C. A., Peskin, M. F., & Wiemann, C. M. (2015) · Maternal and Child Health Journal · doi:10.1007/s10995-015-1733-y · Cited by 42
Resistance Exercise in Pregnancy and Outcome
Barakat, R., & Perales, M. (2016) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000213 · Cited by 36
Abuse as a risk factor for prenatal depressive symptoms: a meta-analysis
Shamblaw, A. L., Cardy, R. E., Prost, E., & Harkness, K. L. (2019) · Archives of Women's Mental Health · doi:10.1007/s00737-018-0900-8 · Cited by 37
Non-communicable diseases and maternal health: a scoping review
Firoz, T., Pineles, B. L., Navrange, N., Grimshaw, A. A., Oladapo, O. T., & Chou, D. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-05047-6 · Cited by 47
Measures of suicidality in perinatal women: A systematic review
Dudeney, E., Coates, R., Ayers, S., & McCabe, R. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.091 · Cited by 34
Prevalence and predictors of symptoms of Perinatal Mood and anxiety Disorders among a sample of Urban Black Women in the South
Hernandez, N., Francis, S., Allen, M., Bellamy, E., Sims, O. T., Oh, H., Guillaume, D., Parker, A. G., & Chandler, R. D. (2022) · Maternal and Child Health Journal · doi:10.1007/s10995-022-03425-2 · Cited by 36
“Previous studies have reported rates of PMADs among Black women between 7% and 40% (Evans et al., 2015; Liu & Tronick, 2014; Melville et al., 2010; Rich-Edwards et al., 2006).”
Yoga Reduces Prenatal Depression Symptoms
Mitchell, J., Field, T. M., Diego, M., Bendell, D., Newton, R. R., & Peláez, M. (2012) · Psychology · doi:10.4236/psych.2012.329118 · Cited by 35
Immigrant status, antenatal depressive symptoms, and frequency and source of violence: what's the relationship?
Miszkurka, M., Zunzunegui, M. V., & Goulet, L. (2012) · Archives of Women s Mental Health · doi:10.1007/s00737-012-0298-7 · Cited by 33
“Abused pregnant women are at higher risk of depression than non-abused pregnant women (Dunn and Oths 2004; Flach et al. 2011; Melville et al. 2010; Silverman and Loudon 2010) and have more severe depressive symptoms (Pico-Alfonso et al.”
Background
Maternal perceived stress and the increased risk of preterm birth in a majority non-Hispanic Black pregnancy cohort
Kornfield, S. L., Riis, V. M., McCarthy, C., Elovitz, M. A., & Burris, H. H. (2021) · Journal of Perinatology · doi:10.1038/s41372-021-01186-4 · Cited by 38

Authors: Melville, J. L., Gavin, A., Guo, Y., Fan, M.-Y., & Katon, W. J.
Affiliations: University of Washington (US)
ORCID: Gavin, Amelia
Guo, Yuqing
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2010-11
Volume: 116
Issue: 5
Pages: 1064-1070
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1097/aog.0b013e3181f60b0a
PMC: PMC3068619
OpenAlex: W1969021057
Cited by: 329
References: 49
Citations by year: 2026: 12 · 2025: 16 · 2024: 13 · 2023: 20 · 2022: 24 · 2021: 24 · 2020: 33 · 2019: 25 · 2018: 25 · 2017: 24 · 2016: 15 · 2015: 29 · 2014: 18 · 2013: 17 · 2012: 22
FWCI: 16.22
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders: National Institutes of Health (1kl2rr025015-01)
National Institute of Mental Health (K24MH069471, R01MH085668)
National Center for Research Resources (KL2-RR025015, 1KL2-RR-025015-01)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD042828)
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
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Keywords: antenatal depression, major depressive disorder, minor depression, panic disorder, suicidal ideation, pregnancy, prevalence, risk factors, psychosocial stress, domestic violence, chronic disease, ethnicity, Hispanic women, Asian women, African American women
MeSH terms: Adolescent, Adult, Depressive Disorder, Female, Humans, Middle Aged, Pregnancy, Pregnancy Complications, Risk Factors, Spouse Abuse, Stress, Psychological, Suicide, Urban Population, Prevalence, Panic Disorder, Young Adult

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Depressive Disorders During Pregnancy: Prevalence and Risk Factors in a Large Urban Sample

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