title: Pregnancy and levels of depression and anxiety: a prospective cohort study of Australian women.
abstract: OBJECTIVE
  The effects of pregnancy on depression and anxiety remain unclear. Previous research is predominantly cross-sectional, not representative of the general community, and does not include data on mental health prior to pregnancy. This study used longitudinal Australian population-based data to examine whether pregnancy is associated with increases in women's anxiety and depression levels (from pre-pregnancy).
  
  
  METHODS
  A community sample of Australian women aged 20-24 years were recruited prospectively and assessed in 1999, 2003 and 2007. At the follow-up assessments 76 women were pregnant (with no prior children) and 542 remained nulliparous. Mixed models repeated measures analyses of variance were undertaken to compare change in levels of anxiety and depression (Goldberg Anxiety and Depression scales) between those who became pregnant and those who remained non-pregnant.
  
  
  RESULTS
  Pregnancy was not associated with increased symptoms of depression or anxiety. No association was found with depression, while pregnancy was associated with a decrease in anxiety. Including somatic items in the measures of depression and anxiety resulted in higher symptom levels in pregnancy, suggesting possible item bias.
  
  
  CONCLUSIONS
  This study is one of the first to follow a community sample of women from pre-pregnancy to pregnancy. The findings suggest that pregnancy is not typically detrimental to women's mental health. The current study offers a starting point for future prospective studies to follow women from pre-pregnancy to postpartum. Study limitations to be improved upon in follow-up research include expanding the sample size, and including both pregnancy-specific measures and trimester-specific data. Future research should continue to identify those women who are most (and least) at risk during pregnancy in order to target resources and assistance most effectively.
authors.affiliation: Psychiatric Epidemiology and Social Issues Unit, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia Liana.Leach@anu.edu.au.
authors.forename: Liana S
authors.initials: LS
authors.lastname: Leach
authors.affiliation: Black Dog Institute, Prince of Wales Hospital, Randwick, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Christensen
authors.affiliation: ORYGEN Research Centre, The University of Melbourne, Melbourne, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mackinnon
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011446:Prospective Studies; D055815:Young Adult
keywords: Antenatal; anxiety; depression; longitudinal; pregnancy; prospective