Preventing postnatal depression

Postnatal depression (PND) affects many women around the world and can limit women’s own ongoing wellbeing, as well as their capacity to enjoy being a parent and engaging with their infants.

Mothers who experience mental health problems during their adolescence or young adulthood are most at risk. Mothers with previous mental health problems are up to 5 times more likely to experience PND than those without.

New research, led by Dr Elizabeth Spry (Deputy Director of VIHCS at the Murdoch Children’s Research Institute, Centre for Adolescent Health) explored potential ways to prevent PND for at risk women. Using a sample of 398 mothers (600 pregnancies) from the Victorian Intergenerational Health Cohort Study (VIHCS), whose mental health was assessed 12 times over 20 years, from adolescence to the first year postpartum.

They found that more than half the risk of PND in mothers with pre-pregnancy symptoms was mediated by depressive symptoms and lack of social support during pregnancy. Partner support was particularly important in reducing the risk of PND for these mothers.

Findings suggest that we could potentially halve the risk of PND for at risk mothers by effective intervention during pregnancy, to reduce their depressive symptoms and improve their social support and quality relationships.

Even greater opportunities to prevent PND may arise from a greater investment in preconception care, to disrupt the complex pathways increasing the risk of PND. The research found persistent mental health problems from adolescence were associated with the greatest increase in risk of PND symptoms.

Investing in adolescent mental health and education around healthy relationships may limit mental health symptom persistence and strengthen social support before pregnancy.

Intervening well before pregnancy benefits women’s health and, it benefits the health and development of the next generation. 

Spry, E. A., Moreno-Betancur, M., Middleton, M., Howard, L. M., Brown, S. J., Molyneaux, E., Greenwood, C. J., Letcher, P., Macdonald, J. A., Thomson, K. C., Biden, E. J., Olsson, C. A., & Patton, G. C. (2021). Preventing postnatal depression: a causal mediation analysis of a 20-year preconception cohort. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 376(1827), 20200028.


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