title: Older first-time mothers and early postpartum depression: a prospective cohort study of women conceiving spontaneously or with assisted reproductive technologies.
abstract: OBJECTIVE
  To evaluate whether older first-time mothers (≥37 years) have higher rates of postpartum depression compared with younger first-time mothers, controlling for mode of conception and known risk factors for postpartum depression.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Assisted reproductive technology (ART) clinics in two large Australian cities and public and private antenatal clinics and/or classes in the vicinity of ART clinics.
  
  
  METHODS
  Nulliparous women who had conceived spontaneously (n = 295) or through ART (n = 297) in three age-groups: younger, 20 to 30 years (n = 173); middle, 31 to 36 years (n = 214); and older, ≥37 years (n = 189).
  
  
  METHODS
  Semistructured interviews and questionnaires.
  
  
  METHODS
  Major depressive disorder in the first 4 months after birth as assessed by structured diagnostic interview.
  
  
  RESULTS
  The study performed 592 complete pregnancy assessments and 541 postpartum assessments. The prevalence of major depressive disorder was 7.9%, at the lower end of community rates. Neither maternal age-group nor mode of conception was statistically significantly related to depression.
  
  
  CONCLUSIONS
  Older first-time mothers, whether conceiving through ART or spontaneously, do not show increased vulnerability to postnatal depression.
authors.affiliation: Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia. cathy.mcmahon@mq.edu.au
authors.forename: Catherine A
authors.initials: CA
authors.lastname: McMahon
authors.forename: Jacky
authors.initials: J
authors.lastname: Boivin
authors.forename: Frances L
authors.initials: FL
authors.lastname: Gibson
authors.forename: Jane R W
authors.initials: JR
authors.lastname: Fisher
authors.forename: Karin
authors.initials: K
authors.lastname: Hammarberg
authors.forename: Karen
authors.initials: K
authors.lastname: Wynter
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Saunders
mesh_terms: D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D016015:Logistic Models; D009517:New South Wales; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted / Q000523:psychology*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014739:Victoria; D055815:Young Adult