The contribution of life events to depression, adjusted for anxiety and somatic symptoms, in mothers during the perinatal period: a prospective cohort study

There is evidence that life events experienced during the perinatal period, such as relationship breakdown, increase the risk of depression. In addition, clinical comorbidity with anxiety and somatic symptoms is common during the perinatal period and is associated with more negative outcomes for the mother and child. However, few studies have investigated the association between life events and depression symptoms whilst controlling for comorbidity with anxiety and somatic symptoms. This study aimed to explore the associations between the number and type of life events and depression symptoms across the perinatal period, whilst controlling for age, deprivation levels, comorbid anxiety and somatic symptoms. Cross-sectional associations were explored at three time-points during the perinatal period (26 weeks pregnancy, 8 weeks postnatal and 1 year postnatal) and prospective associations were explored between life events during pregnancy and postnatal depression symptoms. Data from 917 women who took part in the Born and Bred in Yorkshire population cohort study between 2011-2015 were analysed. Depression, anxiety and somatic symptoms were assessed by the PHQ-8, GAD-7 and PHQ-15 respectively. Life events were assessed using the LTEQ which is a 12-item checklist measure. Results showed that specific types of life events were stronger predictors of perinatal depression symptoms than the number of life events alone. In particular, life events such as relationship breakdown and serious financial problems in the preceding six months were associated with concurrent perinatal depression symptoms in the cross-sectional analyses. The prospective analyses showed that serious problems in a woman’s social network (close friends and relatives) that occurred during pregnancy and soon after childbirth increased the likelihood of experiencing postnatal depression by approximately three times (OR 2.8-3.7). Moreover, problems in a woman’s social network during pregnancy were also shown to increase the risk of postnatal depression independently to depression, anxiety and somatic symptoms during pregnancy. Significant interpersonal and financial life events increase the risk of depression in women during the perinatal period. The results of this study are relevant to public health policymakers and suggestions for clinical implications and further research are discussed.