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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Background
Antenatal depressive symptoms among Canadian-born and immigrant women in Quebec: differential exposure and vulnerability to contextual risk factors
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Background
Therapeutic Drug Monitoring in Pregnancy
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“Depression during pregnancy is a commonly encountered problem with 10% of women meeting the criteria for a probable antenatal depressive disorder in a recently conducted prevalence study.(39) The potentially negative consequences of untreated depression including an increased rate of pregnancy complications(40) and a…”
Background
Mental health of women who suffer intimate partner violence during pregnancy
Fonseca‐Machado, M. D. O., Alves, L. C., Freitas, P. S., Monteiro, J. C. D. S., & Gomes-Sponholz, F. A. (2014) · Investigación y Educación en Enfermería · doi:10.17533/udea.iee.v32n2a12 · Cited by 28
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Background
Perspectives on Early Screening and Prompt Intervention to Identify and Treat Maternal Perinatal Mental Health. Protocol for a Prospective Multicenter Study in Italy
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“SI affects ~20% of US womenwith perinatal depression [3,4], which is considerably greater than 3e4% in the broader US perinatal population [5,6].”
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Huang, Y., Alvernaz, S. A., Kim, S. J., Maki, P. M., Dai, Y., & Bernabé, B. P. (2024) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2024.100376 · Cited by 30
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“However, some research reported that younger age was a risk factor for psychiatric disorders in pregnant women.(34,35) Interestingly, this study revealed that 29.”
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Smoking Patterns, Depression, and Sociodemographic Variables Among Flemish Women During Pregnancy and the Postpartum Period
Wilde, K. S. D., Trommelmans, L., Laevens, H., Maes, L., Temmerman, M., & Boudrez, H. (2013) · Nursing Research · doi:10.1097/nnr.0b013e3182a59d96 · Cited by 24
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“In summary, pregnancy is a window of vulnerability for depression with prevalence rates reported to range from 6.5 to 20% of all pregnant women (Gavin et al., 2005; Marcus, 2009; Melville et al., 2010).”
BackgroundInfluential
Maternal Psychosocial Risk Profiles in Pregnancy: Associations With Postpartum Maternal Health and Child Outcomes
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“, 2007; Melville, Gavin, Guo, Fan, & Katon, 2010), particularly within urban (Melville et al., 2010) and culturallydiverse populations (Connelly et al.”
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“Anxiety, stress, and depressed mood are prevalent during the transition to parenthood, negatively impacting birth outcomes and maternal quality of life (Dunkel Schetter & Glynn, 2011; Melville, Gavin, Guo, Fan, & Katon, 2010; Verreault et al., 2012; Woods et al., 2010).”
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Goodman, S. H., & Dimidjian, S. (2012) · The Canadian Journal of Psychiatry · doi:10.1177/070674371205700903 · Cited by 20
Prenatal antidepressant exposures and gastrointestinal complaints in childhood: A gut–brain axis connection?
Salisbury, A. L., Papandonatos, G. D., Stroud, L. R., Smith, A. K., & Brennan, P. A. (2020) · Developmental Psychobiology · doi:10.1002/dev.21966 · Cited by 19
Polybrominated Diphenyl Ether Serum Concentrations and Depressive Symptomatology in Pregnant African American Women
Mutic, A. D., Barr, D. B., Hertzberg, V., Dunlop, A., Brennan, P., & McCauley, L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073614 · Cited by 18
Obstetric care providers are able to assess psychosocial risks, identify and refer high-risk pregnant women: validation of a short assessment tool – the KINDEX Greek version
Spyridou, A., Schauer, M., & Ruf‐Leuschner, M. (2015) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-015-0462-y · Cited by 17
“It has been associated with a wide variety of medical problems in the mother, as well as with other psychosocial risk factors such as stress and domestic violence [11].”
Background
Role of Race, Ethnicity, and Immigration in Perceived Stress and Depressive Symptomatology Trends During Pregnancy
Toledo‐Corral, C. M., Gao, L., Chavez, T., Grubbs, B. H., Habre, R., Dunton, G. F., Bastain, T. M., & Breton, C. V. (2021) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-021-01235-2 · Cited by 18
Prenatal and Postnatal Maternal Depressive Symptoms Are Associated With White Matter Integrity in 5-Year-Olds in a Sex-Specific Manner
Kumpulainen, V., Copeland, A., Pulli, E. P., Silver, E. A., Kataja, E., Saukko, E., Merisaari, H., Lewis, J. D., Karlsson, L., Karlsson, H., et al. (2023) · Biological Psychiatry · doi:10.1016/j.biopsych.2023.05.014 · Cited by 21
Adverse childhood experiences combined with emotional and physical abuse by the partner predict antenatal depression
Abe, Y., Sirichokchatchawan, W., Sangkomkamhang, U. S., Satthapisit, S., & Maes, M. H. J. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.099 · Cited by 17
Maternal anxiety and its correlation with pain experience during chorion villus sampling and amniocentesis
Klages, K., Kundu, S., Erlenwein, J., Elsaesser, M., Hillemanns, P., Scharf, A., & STABOULIDOU, I. (2017) · Journal of Pain Research · doi:10.2147/jpr.s128300 · Cited by 18
Promoting the well-being of mothers with multidisciplinary psychosocial interventions in the perinatal period
Cauli, G., Iapichino, E., Rucci, P., Quartieri Bollani, M., Marconi, A. M., Bassi, M., & Gala, C. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.12.028 · Cited by 23
Prevalence and factors associated with depression among pregnant mothers in the West Shoa zone, Ethiopia: a community-based cross-sectional study
Tiki, T., Taye, K., & Duko, B. (2020) · Annals of General Psychiatry · doi:10.1186/s12991-020-00275-6 · Cited by 19
Antenatal Depression and its Associated Factors: Findings from Kuwait Birth Cohort Study
Al‐Sabah, R., Al‐Taiar, A., Ziyab, A. H., Akhtar, S., & Hammoud, M. S. (2024) · Journal of Epidemiology and Global Health · doi:10.1007/s44197-024-00223-7 · Cited by 22
Suicide risk assessment: examining transitions in suicidal behaviors among pregnant women in Perú
Levey, E. J., Rondón, M. B., Sánchez, S. E., Zhong, Q., Williams, M. A., & Gelaye, B. (2018) · Archives of Women s Mental Health · doi:10.1007/s00737-018-0884-4 · Cited by 17
Association of dietary patterns and degree of food processing with feelings of depression in pregnancy
Badanai, N. D. L., Zuccolotto, D. C. C., Crivellenti, L. C., & Sartorelli, D. S. (2019) · Revista Brasileira de Saúde Materno Infantil · doi:10.1590/1806-93042019000300006 · Cited by 16
The association between maternal symptoms of depression and hair glucocorticoids in infants across the perinatal period
Karl, M., Huth, V., Schälicke, S., Müller-Stark, C., Weise, V., Mack, J. T., Kirschbaum, C., Weidner, K., Garthus‐Niegel, S., & Steudte‐Schmiedgen, S. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105952 · Cited by 17
Oral microbiome composition is associated with depressive symptoms during pregnancy
Agranyoni, O., Rowley, T., Johnson, S. B., Volk, H. E., Schleif, W. S., Hernandez, R. G., Klein, L. M., Yolken, R. H., & Sabunciyan, S. (2025) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2025.100978 · Cited by 16
“During pregnancy, 10 – 36% of women experience mood symptoms, such as depression and anxiety (Melville et al., 2010; Faculty of Medicine, 2018).”
Effects of in-utero exposure to selective serotonin reuptake inhibitors and venlafaxine on term and preterm infants
Hogue, A. N., Temple, M. E., Lagzdins, M., Worley, S., Scwersenski, J., Floyd, R., & Saker, F. (2017) · Journal of Neonatal-Perinatal Medicine · doi:10.3233/npm-16133 · Cited by 16
“Our findings are consistent with the literature which reports feeding difficulty after in-utero SSRI exposure [3].”
BackgroundResult
Status of Antepartum Depression and Its Influencing Factors in Pregnant Women
Lee, E., & Park, J. S. (2013) · Journal of the Korea Academia-Industrial cooperation Society · doi:10.5762/kais.2013.14.8.3897 · Cited by 15
Hypertensive Disorders of Pregnancy and Symptoms of Depression and Anxiety as Related to Gestational Age at Birth: Findings From the All Our Families Study
Horsley, K. J., Tomfohr‐Madsen, L. M., Ditto, B., & Tough, S. (2019) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000695 · Cited by 15
“In the first model involving depressive symptom severity as the moderator, after adjustment for maternal age, parity, pre-pregnancy BMI, ethnicity, education, and income, the model significantly predicted gestational age at birth, F(9, 2623) = 14.”
BackgroundMethod
Perinatal mental health in low-income urban and rural patients: The importance of screening for comorbidities
Craemer, K. A., Garland, C. E., Sayah, L., Duffecy, J. L., GELLER, S. E., & Maki, P. M. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.05.007 · Cited by 15
Public Health Perspectives on Depressive Disorders
Cohen, N. L. (2017) · Johns Hopkins University Press eBooks · doi:10.1353/book.52762 · Cited by 15
Effect of prenatal administration of venlafaxine on postnatal development of rat offspring
Dubovický, M., Császárová, E., Brnoliaková, Z., Ujházy, E., Navarová, J., & Mach, M. (2012) · Interdisciplinary Toxicology · doi:10.2478/v10102-012-0016-3 · Cited by 14
“The estimated prevalence of depression and other mood disorders in pregnancy ranges from 9 to 16% (Evans et al., 2001; Melville et al, 2010).”
Background
Identificação de sintomas depressivos no período pós-parto em mães adolescentes
Cardillo, V. A., de Oliveira, L. C. Q., Monteiro, J. C. D. S., & Gomes-Sponholz, F. A. (2016) · Revista Eletrônica de Enfermagem · doi:10.5216/ree.v18.32728 · Cited by 14
Maternal psychological distress and associated factors among pregnant women attending antenatal care at public hospitals, Ethiopia
Tesfaye, G., Madoro, D., & Tsegay, L. (2023) · PLoS ONE · doi:10.1371/journal.pone.0280470 · Cited by 17
Psychometric Properties of the Spanish Version of the Pregnancy Related Anxiety Questionnaire (PRAQ)
Vázquez, M., Pereira, B., & Míguez, M. (2018) · The Spanish Journal of Psychology · doi:10.1017/sjp.2018.67 · Cited by 11
The Price of Pre-adolescent Abuse: Effects of Sexual Abuse on Perinatal Depression and Anxiety
Akinbode, T. D., Pedersen, C. A., & Lara-Cinisomo, S. (2020) · Maternal and Child Health Journal · doi:10.1007/s10995-020-03088-x · Cited by 13
“The prevalence of PND in Black women ranges from 7 and 28% (Melville et al. 2010; RichEdwards et al. 2006) and 32–50% in Latina women in the U.”
Background
Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study
Schiele, C., Goetz, M., Hassdenteufel, K., Müller, M., Graf, J., Zipfel, S., & Wallwiener, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.939577 · Cited by 12
“Previous prepartum depression and/or anxiety 4 (13)”
Occupational Hazard Exposures and Depressive Symptoms of Pregnant Workers
Yeh, S., Lee, C., Wu, Y., Tu, N.-C., Guo, Y. L., Chen, P., & Chen, C. (2017) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001255 · Cited by 12
Likelihood of Mental Health and Substance Use Treatment Receipt among Pregnant Women in the USA
Salameh, T. N., Hall, L. A., Crawford, T. N., Staten, R. R., & Hall, M. T. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00247-7 · Cited by 16
“Numerous studies focused on the correlates of mental health problems during pregnancy (Fairbrother et al. 2015, 2016; Le Strat et al. 2011; Melville et al. 2010), but few paid attention to factors associated with mental health treatment receipt.”
Racial/Ethnic Disparities in Depressive Symptoms Among Pregnant Women Vary by Income and Neighborhood Poverty
Cubbin, C., Heck, K. E., Powell, T. M., Marchi, K. S., & Braveman, P. (2015) · AIMS Public Health · doi:10.3934/publichealth.2015.3.411 · Cited by 12
“AIMS Public Health Volume 2, Issue 3, 411-425 Among pregnant women, recent estimates found that approximately 10–13% [2, 3] experience a major depressive episode or meet diagnostic criteria for depression, and up to 20% have reported depressive symptoms during pregnancy [4].”
Background
Prevalence, Correlates, and Outcomes of Co-Occurring Depression and Hypertensive Disorders of Pregnancy
Mogos, M. F., Jones, L. M., Robinson, N., Whitehead, A. O., Piscotty, R., & Goba, G. K. (2019) · Journal of Women s Health · doi:10.1089/jwh.2018.7144 · Cited by 12
Effect of Prenatal Smoke Exposure on Birth Weight: The Moderating Role of Maternal Depressive Symptoms
Schechter, J. C., Do, E. K., Zhang, J. J., Hoyo, C., Murphy, S. K., Kollins, S. H., & Fuemmeler, B. F. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/nty267 · Cited by 11
Racial disparities in emergency mental healthcare utilization among birthing people with preterm infants
Karvonen, K. L., Baer, R. J., Blebu, B. E., Calthorpe, L. M., Fuchs, J. D., Jelliffe‐Pawlowski, L. L., Karasek, D. A., McKenzie‐Sampson, S., Oltman, S. P., Rand, L., et al. (2021) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2021.100546 · Cited by 11
Racial inequities in emergency department wait times for pregnancy-related concerns
Hansen, M. E. D., Goldfarb, S. S., Mercouffer, A., Dark, T., Lateef, H., & Harman, J. S. (2022) · Women s Health · doi:10.1177/17455057221129388 · Cited by 11
Perinatal Complications, Poor Hospital Treatment, and Positive Screen for Postpartum Depressive Symptoms Among Black Women
Nelson, T., Ernst, S. C., & Watson‐Singleton, N. N. (2022) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-022-01322-6 · Cited by 13
Prevalence and Predictors of Depressive Symptoms in Pregnant African American Women
Jallo, N., Elswick, R. K., Kinser, P. A., Masho, S. W., Price, S., & Svikis, D. S. (2015) · Issues in Mental Health Nursing · doi:10.3109/01612840.2015.1048014 · Cited by 11
“…age, as defined as teens and early twenties, was a significant predictor in some studies (Field, Hernandez-Reif et al., 2006; Holzman et al., 2006; Melville et al., 2010) while other studies reported no age associations at 15 weeks EGA (Alder, Fink, Urech, Hosli, & Bitzer, 2011), 16–24 weeks EGA…”
BackgroundInfluential
Marital adjustment and depressive symptoms among Chinese perinatal women: a prospective, longitudinal cross-lagged study
Yang, Y., Luo, B., Ren, J.-H., Deng, X. J., & Guo, X. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-070234 · Cited by 11
“However, the effects of depressive symptoms in the first trimester on marital adjustment in the third trimester and those of marital adjustment in the third trimester on depressive symptoms in the postpartum period are not significant.”
Background
Risk factors and predictive model for prenatal depression: A large retrospective study in China
Liu, Y., Zhang, R., Zhang, Z., Zhou, L., Cheng, B., Liu, X., & Lv, B. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.02.090 · Cited by 10
The Needs and Experiences of Black Families in the Neonatal Intensive Care Unit
Ondusko, D. S., Klawetter, S., Carter, E. H., Osborne, M., Peterson, J. W., Carrasco, V. I. U., Platteau, A., & Hunte, R. S. (2024) · PEDIATRICS · doi:10.1542/peds.2024-067473 · Cited by 10
Perinatal fluoxetine treatment and dams’ early life stress history alter affective behavior in rat offspring depending on serotonin transporter genotype and sex
Houwing, D. J., Schuttel, K., Struik, E. L., Arling, C., Ramsteijn, A. S., Heinla, I., & Olivier, J. D. A. (2020) · Behavioural Brain Research · doi:10.1016/j.bbr.2020.112657 · Cited by 11
Psychiatric Disorders during Pregnancy and Postpartum
Sharma, P., Singh, N., Tempe, A., & Malhotra, M. (2017) · Journal of Pregnancy and Child Health · doi:10.4172/2376-127x.1000317 · Cited by 11
Long-Term Effects of the Periconception Period on Embryo Epigenetic Profile and Phenotype: The Role of Stress and How This Effect Is Mediated
Ord, J., Fazeli, A., & Watt, P. J. (2017) · Advances in experimental medicine and biology · doi:10.1007/978-3-319-62414-3_7 · Cited by 9
Causal links to missed Australian midwifery care: What is the evidence?
Blackman, I. R., Hadjigeorgiou, E., & McNeill, L. (2020) · European Journal of Midwifery · doi:10.18332/ejm/127769 · Cited by 9
Brain-Derived Neurotrophic Factor (BDNF) Depression and Subjective Sleep Quality in the First Trimester of Pregnancy Among Migrant Workers in Thailand
Kriengtuntiwong, T., Zaw, Y. H., & Taneepanichskul, N. (2021) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s322355 · Cited by 9
“In a previous study of depression during pregnancy, high-income countries were shown to have a prevalence between 7–20% while the prevalence in low- and middle-income countries was 20% or more.(3) Another previous study found that the rate of depression was highest during the first trimester and lower in the second an…”
Background

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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