Depressive mood in early pregnancy and postpartum:: prevalence and women at risk in a national Swedish sample

We investigated the prevalence of postnatal depressive mood in a national Swedish sample, together with factors associated with depressed mood postpartum only as opposed to having depressed mood both in early pregnancy and postpartum. Swedish-speaking women booked for antenatal care during a chosen period of three recruitment weeks were invited and 3293 (72%) agreed to participate in the study. Of these women, 2674 (81%) completed two questionnaires, one in early pregnancy and another 2 months postpartum. Depressive mood was assessed by the Edinburgh Postnatal Depression Scale (EPDS) and the validated Swedish cut-off of 11/12 was used. In all, 12.3% scored above the threshold postpartum depressed mood, that being 6.5% postpartum only ('post' group) and 5.8% both in pregnancy and postpartum ('ante and post' group). Unemployment, lack of support, and physical health problems were the most important factors associated with a postpartum depressed mood in both groups. Women in the 'ante and post' group were more socially disadvantaged with increased relative risks in most of the factors that were investigated. Postnatal problems such as dissatisfaction with support from relatives and factors related to the infant were only associated with a depressed mood in the 'post' group. Obtaining a psychosocial history in early pregnancy, including factors associated with a depressed mood, may be the first step towards identifying and providing individualized care for women at risk of sustained or recurrent depressive mood during pregnancy and the postpartum period.