Depression During Pregnancy

Heather A. Bennett; Adrienne Einarson; Anna Taddio; Gideon Koren; Thomas R. Einarson


Clin Drug Invest. 2004;24(3) 

In This Article

Epidemiology of Depression during Pregnancy

Published reports of the prevalence of depression during the gestational period have increased dramatically over recent years. Eight studies were published between 1985 and 1995, compared with 21 between 1996 and 2003. Despite increased research into the epidemiology of this disorder, there is still considerable uncertainty as to the numbers of women affected. Rates determined by structured interview have ranged from 2 to 21%[13,62,63] and up to 38% for women of low SES.[20] Estimates derived from self-report questionnaires have ranged from 8 to 31%[11,12,14,16,18,64,65,66,67,68,69,70] and 20 to 51%,[21,71,72] respectively. Table II summarises studies that have estimated the prevalence of depression during pregnancy.

To obtain an explanation for such a wide variation, it is necessary to consider the methods used within the original articles. Researchers have used a variety of instruments to detect depression and depressive symptoms. Not all have been validated for pregnancy. It is possible that the use of such instruments may have measured pregnancy-related somatic symptoms as well as the depression itself. Furthermore, researchers have used modified instruments and varying cutoff scores. Rates derived from the use of such instruments may not provide a 'true' estimate of prevalence in this population. However, the consequences of such use are unknown and may in part contribute to the variation in observed rates.

Another reason for the discrepancies between study outcomes may be that estimates have been determined at different stages of pregnancy. The progression of pregnancy may have an impact upon depression status. If so, it would be necessary to specify the time of the prevalence measurement relative to the stage of pregnancy. In addition, although the prevalence of depression has not been shown to be dependent on race,[81] it has been shown to be negatively correlated with SES.[35] Therefore, it is important that data from patients with low SES be analysed separately.

To ensure adequacy of healthcare resources, a more precise estimate of the number of women with prenatal depression is required. Systematically combining the available studies based on: (i) the SES of the participants and (ii) the method of determination of depression may provide such an estimate. To date, no such research has been identified.


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