Restricted accessResearch articleFirst published online 2020-8
Informal and formal social support during pregnancy and joint maternal and paternal postnatal depression: Data from the French representative ELFE cohort study
Insufficient social support has been intensively studied as a risk factor of postpartum depression (PPD) among mothers. However, to date, no study has examined the role of informal and formal dimensions of social support during pregnancy with regard to joint maternal and paternal depression after birth.
Aim:
Study associations between insufficient informal and formal support during pregnancy and joint parental PPD.
Methods:
Using data from the nationally representative French ELFE (Etude Longitudinale Française depuis l’Enfance) cohort study (N = 12,350), we estimated associations between insufficient informal and formal support received by the mother during pregnancy and joint parental PPD in multi-imputed multivariate multinomial regression models.
Results:
In 166 couples (1.3%), both parents were depressed. The likelihood of joint parental PPD was increased in case of insufficient informal support (insufficient partner support: odds ratio (OR) = 1.68 (95% confidence interval (CI): 1.57–1.80); frequent quarrels: OR = 1.38 (95% CI: 1.19–1.60)). We also observed associations between formal support during pregnancy and joint parental PPD (early prenatal psychosocial risk assessment: OR = 1.13 (95% CI: 1.05–1.22); antenatal education: OR = 1.13 (95% CI: 1.05–1.23)), which disappeared when analyses were restricted to women with no psychological difficulties during pregnancy.
Conclusion:
Insufficient informal social support during pregnancy appears to predict risk of joint PPD in mothers and fathers and should be identified early on to limit complications and the impact on children.
BarandonS.BalesM.MelchiorM.Glangeaud-FreudenthalN.PambrunE.BoisC.VerdouxH.Sutter-DallayA.-L. (2016). Early prenatal interview and antenatal education for childbirth and parenthood: Associated psychosocial and obstetric characteristics in women of the ELFE cohort. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 45(6), 599–607.
2.
BauerA.KnappM.ParsonageM. (2016). Lifetime costs of perinatal anxiety and depression. Journal of Affective Disorders, 192, 83–90.
3.
CameronE. E.SedovI. D.Tomfohr-MadsenL. M. (2016). Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. Journal of Affective Disorders, 206(Suppl. C), 189–203.
4.
ChandonnetN.SaeyDAlmerasNMarcI (2012). French Pregnancy Physical Activity Questionnaire compared with an accelerometer cut point to classify physical activity among pregnant obese women. PloS one, 7(6).
5.
CharandabiM.-A.MirghafourvandM.SanaatiF. (2017). The effect of life style based education on the fathers’ anxiety and depression during pregnancy and postpartum periods: A randomized controlled trial. Community Mental Health Journal, 53(4), 482–489.
6.
CharlesM.-A.ThierryX.LanoeJ.-L.BoisC.DufourgM. N.PopaR.CheminatM.ZarosC.GeayB. (2019). Cohort profile: The French National cohort of children ELFE: Birth to 5 years. International Journal of Epidemiology. Advance online publication. https://doi.org/10.1093/ije/dyz227
7.
CoxJ. L.HoldenJ. M.SagovskyR. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150(6), 782–786.
8.
EdmondsonO. J.PsychogiouL.VlachosH.NetsiE.RamchandaniP. G. (2010). Depression in fathers in the postnatal period: Assessment of the Edinburgh Postnatal Depression Scale as a screening measure. Journal of Affective Disorders, 125(1–3), 365–368.
9.
EdwardK.CastleD.MillsC.DavisL.CaseyJ. (2014). An integrative review of paternal depression. American Journal of Men’s Health, 9(1), 26–34.
10.
El-KhouryF.Sutter-DallayA.-L.PanicoL.CharlesM.-A.AzriaE.Van der WaerdenJ.MelchiorM. (2018). Women’s mental health in the perinatal period according to migrant status: The French representative ELFE birth cohort. The European Journal of Public Health, 28(3), 458–463.
11.
GaynesB. N.GavinN.Meltzer-BrodyS.LohrK. N.SwinsonT.GartlehnerG.BrodyS.MillerW. C. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes: Summary. Agency for Healthcare Research Quality.
12.
Glangeau-FreudenthalN. (2017). Welcoming fathers in the perinatal period. Erès.
13.
GreenhalghR.SladeP.SpibyH. (2000). Fathers’ coping style, antenatal preparation, and experiences of labor and the postpartum. Birth, 27(3), 177–184.
14.
GuedeneyN.FermanianJ. (1998). Validation study of the French version of the Edinburgh Postnatal Depression Scale (EPDS): New results about use and psychometric properties. European Psychiatry, 13(2), 83–89.
15.
HaberM. G.CohenJ. L.LucasT.BaltesB. B. (2007). The relationship between self-reported received and perceived social support: A meta-analytic review. American Journal of Community Psychology, 39(1–2), 133–144.
16.
Haute Autorité de Santé. (2006). Preparation for birth and parenthood (PNP). Professional Recommendations. Recommandations Professionnelles.
17.
IsserlisC.Sutter-DallayA.Glangeaud-FreudenthalN. (2008). Guide for the practice of early prenatal maintenance. Érès.
18.
JohanssonM.SvenssonI.StenströmU.MassoudiP. (2017). Depressive symptoms and parental stress in mothers and fathers 25 months after birth. Journal of Child Health Care, 21(1), 65–73.
19.
JohnsonJ. G.CohenP.KasenS.BrookJ. S. (2008). Parental concordance and offspring risk for anxiety, conduct, depressive, and substance use disorders. Psychopathology, 41(2), 124–128.
20.
KerstisB.AartsC.TillmanC.PerssonH.EngströmG.EdlundB.ÖhrvikJ.SylvénS.SkalkidouA. (2016). Association between parental depressive symptoms and impaired bonding with the infant. Archives of Women’s Mental Health, 19(1), 87–94.
21.
KerstisB.BerglundA.EngströmG.EdlundB.SylvénS.AartsC. (2014). Depressive symptoms postpartum among parents are associated with marital separation: A Swedish cohort study. Scandinavian Journal of Public Health, 42(7), 660–668.
22.
LeungB. M.LetourneauN. L.GiesbrechtG. F.NtandaH.HartM. (2017). Predictors of postpartum depression in partnered mothers and fathers from a longitudinal cohort. Community Mental Health Journal, 53(4), 420–431.
23.
MassoudiP.HwangC. P.WickbergB. (2013). How well does the Edinburgh Postnatal Depression Scale identify depression and anxiety in fathers? A validation study in a population based Swedish sample. Journal of Affective Disorders, 149(1–3), 67–74.
24.
MassoudiP.HwangC. P.WickbergB. (2016). Fathers’ depressive symptoms in the postnatal period: Prevalence and correlates in a population-based Swedish study. Scandinavian Journal of Public Health, 44(7), 688–694.
25.
MattheyS.BarnettB.UngererJ.WatersB. (2000). Paternal and maternal depressed mood during the transition to parenthood. Journal of Affective Disorders, 60(2), 75–85.
26.
MattheyS.KavanaghD. J.HowieP.BarnettB.CharlesM. (2004). Prevention of postnatal distress or depression: An evaluation of an intervention at preparation for parenthood classes. Journal of Affective Disorders, 79(1–3), 113–126.
27.
MelroseK. L.BrownG. D.WoodA. M. (2015). When is received social support related to perceived support and well-being? When it is needed. Personality and Individual Differences, 77, 97–105.
28.
MorrellC. J.SutcliffeP.BoothA.StevensJ.ScopeA.StevensonM.HarveyR.BesseyA.CantrellA.DennisC.-L. (2016). A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment, 20(37), 1–414.
29.
MurrayL.HalliganS.CooperP. (2018). Postnatal depression and young children’s development. In ZeanahC. (Ed.), Handbook of infant mental health (pp. 172–186). Guilford Publications.
30.
O’HaraM. W.McCabeJ. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9(1), 379–407.
31.
PaulsonJ. F.BazemoreS. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. Journal of the American Medical Association, 303(19), 1961–1969.
32.
PaulsonJ. F.DauberS.LeifermanJ. A. (2006). Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics, 118(2), 659.
33.
PrembergA.LundgrenI. (2006). Fathers’ experiences of childbirth education. The Journal of Perinatal Education, 15(2), 21–28.
34.
PsouniE.AgebjörnJ.LinderH. (2017). Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool. Scandinavian Journal of Psychology, 58(6), 485–496.
35.
RamchandaniP.SteinA.EvansJ.O’ConnorT. G. (2005). Paternal depression in the postnatal period and child development: A prospective population study. The Lancet, 365(9478), 2201–2205.
36.
RamchandaniP. G.PsychogiouL.VlachosH.IlesJ.SethnaV.NetsiE.LodderA. (2011). Paternal depression: An examination of its links with father, child and family functioning in the postnatal period. Depression and Anxiety, 28(6), 471–477.
37.
RedshawM.HendersonJ. (2013). Fathers’ engagement in pregnancy and childbirth: Evidence from a national survey. BMC Pregnancy and Childbirth, 13(1), Article 70.
38.
RobertsonE.GraceS.WallingtonT.StewartD. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry, 26(4), 289–295.
39.
ShapiroA. F.GottmanJ. M. (2005). Effects on marriage of a psycho-communicative-educational intervention with couples undergoing the transition to parenthood, evaluation at 1-year post intervention. The Journal of Family Communication, 5(1), 1–24.
40.
SimpsonJ. A.RholesW. S.CampbellL.TranS.WilsonC. L. (2003). Adult attachment, the transition to parenthood, and depressive symptoms. Journal of Personality and Social Psychology, 84(6), 1172–1187.
41.
ThierryX.PilorinT.LanoëJ.-L. (2018). The Elf cohort: Which children is it and will it be representative of? Comprendre le social dans la durée. Les études longitudinales en sciences sociales. Presses Universitaires de Rennes (PUR), 49–63.
42.
Van BuurenS.BrandJ. P.Groothuis-OudshoornC.RubinD. B. (2006). Fully conditional specification in multivariate imputation. Journal of Statistical Computation and Simulation, 76(12), 1049–1064.
43.
Van der WaerdenJ.GaléraC.Saurel-CubizollesM.-J.Sutter-DallayA.-L.MelchiorE. D. E. N. & Mother-Child Cohort Study Group. (2015). Predictors of persistent maternal depression trajectories in early childhood: Results from the EDEN Mother–Child Cohort Study in France. Psychological Medicine, 45(9), 1999–2012.
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