Skip to main content
Top
Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Determinants of antenatal depression and postnatal depression in Australia

Authors: Felix Akpojene Ogbo, John Eastwood, Alexandra Hendry, Bin Jalaludin, Kingsley E. Agho, Bryanne Barnett, Andrew Page

Published in: BMC Psychiatry | Issue 1/2018

Login to get access

Abstract

Background

Depression is a leading source of morbidity and health loss in Australian women. This study investigates the determinants of antenatal depressive symptoms and postnatal depressive symptoms in an Australian population, including people from culturally and linguistically diverse (CALD) backgrounds.

Method

The study used a retrospective cohort of mothers of all live births in public health facilities in 2014 (N = 17,564) within South Western Sydney Local Health District and Sydney Local Health District in New South Wales, Australia. Prevalence of antenatal and postnatal depressive symptoms were estimated for the cohort. Multivariate logistic regression models were conducted to investigate the sociodemographic, psychological and health service determinants of antenatal and postnatal depressive symptoms, measured using the Edinburgh Postnatal Depression Scale (EPDS).

Results

The prevalence of antenatal and postnatal depressive symptoms was 6.2% and 3.3% of the cohort, respectively. Significant risk factors for maternal depressive symptoms during pregnancy were, a lack of partner support, history of intimate partner violence, being from the CALD population and low socioeconomic status. Self-reported antenatal depressive symptoms were strongly associated with postnatal depressive symptoms. Risk factors for postnatal depressive symptoms were similar to those for antenatal depressive symptoms, as well as assisted delivery.

Conclusion

Factors relating to demographic and psychosocial disadvantage were associated with subsequent antenatal and postnatal depressive symptoms in New South Wales, Australia. Our study suggests that screening for probable depression and timely referral for expert assessment of at-risk mothers may be an effective strategy to improve maternal mental health outcomes.
Literature
2.
go back to reference Hay IS, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1260–344.CrossRef Hay IS, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1260–344.CrossRef
3.
go back to reference Dias CC, Figueiredo B. Breastfeeding and Depression: a systematic review of the literature. J Affect Disord. 2015;171:142–54.CrossRefPubMed Dias CC, Figueiredo B. Breastfeeding and Depression: a systematic review of the literature. J Affect Disord. 2015;171:142–54.CrossRefPubMed
4.
go back to reference beyondblue National Postnatal Depression Program. The beyondblue National Postnatal Depression Program Prevention and Early Intervention 2001–2005. 2005. beyondblue National Postnatal Depression Program. The beyondblue National Postnatal Depression Program Prevention and Early Intervention 2001–2005. 2005.
5.
go back to reference Grigoriadis S, EH VP, Mamisashvili L, Tomlinson G, Dennis C-L, Koren G, et al. the impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. The Journal of clinical psychiatry. 2013;74(4):321–41.CrossRef Grigoriadis S, EH VP, Mamisashvili L, Tomlinson G, Dennis C-L, Koren G, et al. the impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. The Journal of clinical psychiatry. 2013;74(4):321–41.CrossRef
6.
go back to reference Gentile S. Untreated depression during pregnancy: short-and long-term effects in offspring. A systematic review. Neuroscience. 2015 Gentile S. Untreated depression during pregnancy: short-and long-term effects in offspring. A systematic review. Neuroscience. 2015
7.
go back to reference Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R. Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry. 2004;61(9):946–52.CrossRefPubMed Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R. Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry. 2004;61(9):946–52.CrossRefPubMed
8.
go back to reference Zuckerman B, Amaro H, Bauchner H, Cabral H. Depressive symptoms during pregnancy: relationship to poor health behaviors. Am J Obstet Gynecol. 1989;160(5):1107–11.CrossRefPubMed Zuckerman B, Amaro H, Bauchner H, Cabral H. Depressive symptoms during pregnancy: relationship to poor health behaviors. Am J Obstet Gynecol. 1989;160(5):1107–11.CrossRefPubMed
9.
go back to reference Gotlib IH, Hammen CL. Handbook of depression. New York, USA: Guilford Press; 2008. Gotlib IH, Hammen CL. Handbook of depression. New York, USA: Guilford Press; 2008.
11.
go back to reference Navaratne P, Foo XY, Kumar S. Impact of a high Edinburgh postnatal depression scale score on obstetric and perinatal outcomes. Sci Rep. 2016;6 Navaratne P, Foo XY, Kumar S. Impact of a high Edinburgh postnatal depression scale score on obstetric and perinatal outcomes. Sci Rep. 2016;6
12.
go back to reference Leigh B, Milgrom J. Risk Factors for antenatal depression, postnatal depression and parenting stress. BMC psychiatry. 2008;8(1):1.CrossRef Leigh B, Milgrom J. Risk Factors for antenatal depression, postnatal depression and parenting stress. BMC psychiatry. 2008;8(1):1.CrossRef
13.
go back to reference Eastwood JG, Phung H, Barnett B. Postnatal depression and socio-demographic risk: factors associated with Edinburgh depression scale scores in a metropolitan area of new South Wales, Australia. Australian & New Zealand Journal of Psychiatry. 2011;45(12):1040–6.CrossRef Eastwood JG, Phung H, Barnett B. Postnatal depression and socio-demographic risk: factors associated with Edinburgh depression scale scores in a metropolitan area of new South Wales, Australia. Australian & New Zealand Journal of Psychiatry. 2011;45(12):1040–6.CrossRef
14.
go back to reference Edwards B, Galletly C, Semmler-Booth T, Dekker G. Antenatal psychosocial risk factors and depression among women living in socioeconomically disadvantaged suburbs in Adelaide, South Australia. Australian & New Zealand Journal of Psychiatry. 2008;42(1):45–50.CrossRef Edwards B, Galletly C, Semmler-Booth T, Dekker G. Antenatal psychosocial risk factors and depression among women living in socioeconomically disadvantaged suburbs in Adelaide, South Australia. Australian & New Zealand Journal of Psychiatry. 2008;42(1):45–50.CrossRef
15.
go back to reference Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108(1):147–57.CrossRefPubMed Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108(1):147–57.CrossRefPubMed
16.
go back to reference beyondblue. Clinical practice guidelines for depression and related disorders—anxiety, bipolar disorder and puerperal psychosis—in the perinatal period. A guideline for primary care health professionals. Melbourne, Australia: beyondblue, 2011. beyondblue. Clinical practice guidelines for depression and related disorders—anxiety, bipolar disorder and puerperal psychosis—in the perinatal period. A guideline for primary care health professionals. Melbourne, Australia: beyondblue, 2011.
17.
go back to reference South Western Sydney Local Health District. Research Strategy for South Western Sydney Local Health District 2012–2021. Sydney, Australia: South Western Sydney Local Health District; 2012. South Western Sydney Local Health District. Research Strategy for South Western Sydney Local Health District 2012–2021. Sydney, Australia: South Western Sydney Local Health District; 2012.
19.
go back to reference Ogbo FA, Eastwood J, Page A, Arora A, McKenzie A, Jalaludin B, et al. prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia. Int Breastfeed J. 2017;12(1):16.CrossRefPubMedPubMedCentral Ogbo FA, Eastwood J, Page A, Arora A, McKenzie A, Jalaludin B, et al. prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia. Int Breastfeed J. 2017;12(1):16.CrossRefPubMedPubMedCentral
20.
go back to reference Australian Bureau of Statistics. Technical Paper: Socio-Economic Indexes for Areas (SEIFA) 2011, 2013. Commonwealth of Australia: Canberra. Australian Bureau of Statistics. Technical Paper: Socio-Economic Indexes for Areas (SEIFA) 2011, 2013. Commonwealth of Australia: Canberra.
22.
go back to reference Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh depression scale (EDDS). Journal of reproductive and infant psychology. 1990;8(2):99–107.CrossRef Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh depression scale (EDDS). Journal of reproductive and infant psychology. 1990;8(2):99–107.CrossRef
23.
go back to reference Murray L, Carothers AD. The validation of the Edinburgh post-natal depression scale on a community sample. Br J Psychiatry. 1990;157(2):288–90.CrossRefPubMed Murray L, Carothers AD. The validation of the Edinburgh post-natal depression scale on a community sample. Br J Psychiatry. 1990;157(2):288–90.CrossRefPubMed
24.
go back to reference Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150(6):782–6.CrossRefPubMed Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150(6):782–6.CrossRefPubMed
25.
go back to reference Hannah P, Adams D, Lee A, Glover V, Sandler M. Links Between early post-partum mood and post-natal depression. Br J Psychiatry. 1992;160(6):777–80.CrossRefPubMed Hannah P, Adams D, Lee A, Glover V, Sandler M. Links Between early post-partum mood and post-natal depression. Br J Psychiatry. 1992;160(6):777–80.CrossRefPubMed
26.
go back to reference Kohlhoff J, Hickinbotham R, Knox C, Roach V, Barnett Am B. Antenatal psychosocial assessment and depression screening in a private hospital. Aust N Z J Obstet Gynaecol. 2016;56(2):173–8.CrossRefPubMed Kohlhoff J, Hickinbotham R, Knox C, Roach V, Barnett Am B. Antenatal psychosocial assessment and depression screening in a private hospital. Aust N Z J Obstet Gynaecol. 2016;56(2):173–8.CrossRefPubMed
27.
go back to reference NSW Department of Health. NSW Health/Families NSW Supporting Families Early Package – SAFE START Guidelines: Improving Mental Health Outcomes for Parents & Infants. In: Health Mo, editor. Sydney NSW Health 2010. p. 9–10. NSW Department of Health. NSW Health/Families NSW Supporting Families Early Package – SAFE START Guidelines: Improving Mental Health Outcomes for Parents & Infants. In: Health Mo, editor. Sydney NSW Health 2010. p. 9–10.
28.
go back to reference Boyce P, Stubbs J, Todd A. The Edinburgh postnatal depression scale: validation for an Australian sample. Aust N Z J Psychiatry. 1993;27(3):472–6.CrossRefPubMed Boyce P, Stubbs J, Todd A. The Edinburgh postnatal depression scale: validation for an Australian sample. Aust N Z J Psychiatry. 1993;27(3):472–6.CrossRefPubMed
29.
go back to reference Leverton T, Elliott S. Is the EPDS a magic wand?: 1. A comparison of the Edinburgh Postnatal Depression Scale and health visitor report as predictors of diagnosis on the Present State Examination. 2000. Leverton T, Elliott S. Is the EPDS a magic wand?: 1. A comparison of the Edinburgh Postnatal Depression Scale and health visitor report as predictors of diagnosis on the Present State Examination. 2000.
30.
go back to reference Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.CrossRefPubMedPubMedCentral Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.CrossRefPubMedPubMedCentral
31.
go back to reference Spratt M, Carpenter J, Sterne JA, Carlin JB, Heron J, Henderson J, et al. Strategies for multiple imputation in longitudinal studies. Am J Epidemiol. 2010;172(4):478–87.CrossRefPubMed Spratt M, Carpenter J, Sterne JA, Carlin JB, Heron J, Henderson J, et al. Strategies for multiple imputation in longitudinal studies. Am J Epidemiol. 2010;172(4):478–87.CrossRefPubMed
32.
go back to reference Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62–77.CrossRefPubMedPubMedCentral Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62–77.CrossRefPubMedPubMedCentral
33.
go back to reference Australian Government Department of Social Services. The National Plan to Reduce Violence against Women and their Children 2010–2022 (the National Plan). In: Department of Social Services, editor. Canberra 2011. Australian Government Department of Social Services. The National Plan to Reduce Violence against Women and their Children 2010–2022 (the National Plan). In: Department of Social Services, editor. Canberra 2011.
34.
go back to reference Australian Department of Human Services. Family and Domestic Violence Strategy 2016–2019. Can Underwrit. 2016; Australian Department of Human Services. Family and Domestic Violence Strategy 2016–2019. Can Underwrit. 2016;
35.
go back to reference Deloitte Access Economics. The cost of perinatal depression in Australia. Canberra, ACT: Deloitte, 2012. Deloitte Access Economics. The cost of perinatal depression in Australia. Canberra, ACT: Deloitte, 2012.
36.
go back to reference New South Wales Ministry of Health. SAFE START Strategic Policy. In: Mental Health and Drug and Alcohol Office, editor. Sydney, Australia: NSW Health; 2010. New South Wales Ministry of Health. SAFE START Strategic Policy. In: Mental Health and Drug and Alcohol Office, editor. Sydney, Australia: NSW Health; 2010.
37.
go back to reference NSW Ministry of Health. Violence Prevention and Response Unit. Domestic Violence Routine Screening Program: Snapshot Report 9. 2012. NSW Ministry of Health. Violence Prevention and Response Unit. Domestic Violence Routine Screening Program: Snapshot Report 9. 2012.
38.
go back to reference NSW Health. SAFE START guidelines: improving mental health outcomes for parents and infants. NSW Health: Sydney, Australia; 2010. NSW Health. SAFE START guidelines: improving mental health outcomes for parents and infants. NSW Health: Sydney, Australia; 2010.
39.
go back to reference Katz I. Community interventions for vulnerable children and families: Participation and power. Communities, Children and Families Australia. 2007;3(1):19. Katz I. Community interventions for vulnerable children and families: Participation and power. Communities, Children and Families Australia. 2007;3(1):19.
42.
go back to reference Northern NSW Local Health District. NNSW integrated care strategy – status report may 2016. New South Wales: Northern NSW Local Health District; 2016. Northern NSW Local Health District. NNSW integrated care strategy – status report may 2016. New South Wales: Northern NSW Local Health District; 2016.
43.
go back to reference Australian Institute of Health and Welfare. Experience of perinatal depression: data from the 2010 Australian National Infant Feeding Survey. Canberra: AIHW, 2012 Contract No.: PHE 161. Australian Institute of Health and Welfare. Experience of perinatal depression: data from the 2010 Australian National Infant Feeding Survey. Canberra: AIHW, 2012 Contract No.: PHE 161.
44.
go back to reference Eastwood JG, Jalaludin BB, Kemp LA, Phung HN, Barnett BE. Relationship of postnatal depressive symptoms to infant temperament, maternal expectations, social support and other potential risk factors: findings from a large Australian cross-sectional study. BMC pregnancy and childbirth. 2012;12(1):148.CrossRefPubMedPubMedCentral Eastwood JG, Jalaludin BB, Kemp LA, Phung HN, Barnett BE. Relationship of postnatal depressive symptoms to infant temperament, maternal expectations, social support and other potential risk factors: findings from a large Australian cross-sectional study. BMC pregnancy and childbirth. 2012;12(1):148.CrossRefPubMedPubMedCentral
45.
go back to reference Rich JL, Byrne JM, Curryer C, Byles JE, Loxton D. Prevalence and correlates of depression among Australian women: a systematic literature review, January 1999-January 2010. BMC research notes. 2013;6(1):424.CrossRefPubMedPubMedCentral Rich JL, Byrne JM, Curryer C, Byles JE, Loxton D. Prevalence and correlates of depression among Australian women: a systematic literature review, January 1999-January 2010. BMC research notes. 2013;6(1):424.CrossRefPubMedPubMedCentral
46.
go back to reference South Western Sydney Local Health District. SWSLHD mental health service: a clinical stream of south western Sydney local Health District. Sydney: SWSLHD; 2013. South Western Sydney Local Health District. SWSLHD mental health service: a clinical stream of south western Sydney local Health District. Sydney: SWSLHD; 2013.
48.
go back to reference Sawrikar P, Katz I. Enhancing family and relationship service accessibility and delivery to culturally and linguistically diverse families in Australia (Vol. 3/2008). Australian Institute of Family Studies, AFRC Issues, Australian Family Relationships Clearinghouse: Melbourne; 2008. Sawrikar P, Katz I. Enhancing family and relationship service accessibility and delivery to culturally and linguistically diverse families in Australia (Vol. 3/2008). Australian Institute of Family Studies, AFRC Issues, Australian Family Relationships Clearinghouse: Melbourne; 2008.
49.
go back to reference Browne J, Renzaho A. Prevention Of alcohol and other drug problems in culturally and linguistically diverse communities. Prevention. research quarterly. 2010;13:1–24. Browne J, Renzaho A. Prevention Of alcohol and other drug problems in culturally and linguistically diverse communities. Prevention. research quarterly. 2010;13:1–24.
50.
go back to reference Bowes J, Grace R. Review of early childhood parenting, education and health intervention programs for indigenous children and families in Australia. Canberra: Australian Institute of Health and Welfare & Melbourne: Australian Institute of Family Studies. 2014; Bowes J, Grace R. Review of early childhood parenting, education and health intervention programs for indigenous children and families in Australia. Canberra: Australian Institute of Health and Welfare & Melbourne: Australian Institute of Family Studies. 2014;
52.
go back to reference Matthey S, Agostini F. Using the Edinburgh postnatal depression scale for women and men—some cautionary thoughts. Archives of women's mental health. 2017;20(2):345–54.CrossRefPubMed Matthey S, Agostini F. Using the Edinburgh postnatal depression scale for women and men—some cautionary thoughts. Archives of women's mental health. 2017;20(2):345–54.CrossRefPubMed
53.
go back to reference Cox J, Holden J. Perinatal mental health: a guide to the Edinburgh postnatal depression scale (EPDS): Royal College of psychiatrists; 2003. Cox J, Holden J. Perinatal mental health: a guide to the Edinburgh postnatal depression scale (EPDS): Royal College of psychiatrists; 2003.
54.
go back to reference Allison KC, Wenzel A, Kleiman K, Sarwer DB. Development of a brief measure of postpartum distress. J Women's Health. 2011;20(4):617–23.CrossRef Allison KC, Wenzel A, Kleiman K, Sarwer DB. Development of a brief measure of postpartum distress. J Women's Health. 2011;20(4):617–23.CrossRef
55.
go back to reference Somerville S, Byrne SL, Dedman K, Hagan R, coo S, Oxnam E, et al. detecting the severity of perinatal anxiety with the perinatal anxiety screening scale (PASS). J Affect Disord. 2015;186:18–25.CrossRefPubMed Somerville S, Byrne SL, Dedman K, Hagan R, coo S, Oxnam E, et al. detecting the severity of perinatal anxiety with the perinatal anxiety screening scale (PASS). J Affect Disord. 2015;186:18–25.CrossRefPubMed
56.
go back to reference Brodey BB, Goodman SH, Baldasaro RE, Brooks-DeWeese A, Wilson ME, Brodey IS, et al. Development of the perinatal depression inventory (PDI)-14 using item response theory: a comparison of the BDI-II, EPDS, PDI, and PHQ-9. Archives of women’s mental health. 2016;19(2):307–16.CrossRefPubMed Brodey BB, Goodman SH, Baldasaro RE, Brooks-DeWeese A, Wilson ME, Brodey IS, et al. Development of the perinatal depression inventory (PDI)-14 using item response theory: a comparison of the BDI-II, EPDS, PDI, and PHQ-9. Archives of women’s mental health. 2016;19(2):307–16.CrossRefPubMed
57.
go back to reference Rothman KJ, Greenland S, Lash TL. Modern epidemiology. Philadelphia, USA: Lippincott Williams & Wilkins; 2008. Rothman KJ, Greenland S, Lash TL. Modern epidemiology. Philadelphia, USA: Lippincott Williams & Wilkins; 2008.
Metadata
Title
Determinants of antenatal depression and postnatal depression in Australia
Authors
Felix Akpojene Ogbo
John Eastwood
Alexandra Hendry
Bin Jalaludin
Kingsley E. Agho
Bryanne Barnett
Andrew Page
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1598-x

Other articles of this Issue 1/2018

BMC Psychiatry 1/2018 Go to the issue