title: Long-term trajectories of maternal depressive symptoms and their antenatal predictors.
abstract: BACKGROUND
  Depressive symptoms, often long-term or recurrent, are common among mothers of young children and a well-known risk for child well-being. We aimed to explore the antecedents of the long-term trajectories of maternal depressive symptoms and to define the antenatal factors predicting the high-symptom trajectories.
  
  
  METHODS
  The sample comprised 329 mothers from maternity centers. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) antenatally and at two months, six months, 4-5 years, 8-9 years and 16-17 years after delivery. Maternal expectations concerning the baby were assessed with the Neonatal Perception Inventory (NPI). Background information was gathered with questionnaires.
  
  
  RESULTS
  A model including four symptom trajectories (very low, low-stable, high-stable and intermittent) was selected to describe the symptom patterns over time. The high-stable and the intermittent trajectory were both predicted pairwise by a high antenatal EPDS sum score as well as high EPDS anxiety and depression subscores but the other predictors were specific for each trajectory. In multivariate analyses, the high-stable trajectory was predicted by a high antenatal EPDS sum score, a high EPDS anxiety subscore, diminished life satisfaction, loneliness and more negative expectations of babies on average. The intermittent trajectory was predicted by a high antenatal EPDS sum score, a poor relationship with own mother and urgent desire to conceive.
  
  
  CONCLUSIONS
  Only self-report questionnaires were used. The sample size was rather small.
  
  
  CONCLUSIONS
  The results suggest a heterogeneous course and background of maternal depressive symptoms. This should be considered in intervention planning.
authors.affiliation: University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland. Electronic address: ilona.luoma@uta.fi.
authors.forename: Ilona
authors.initials: I
authors.lastname: Luoma
authors.affiliation: University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland.
authors.forename: Marie
authors.initials: M
authors.lastname: Korhonen
authors.affiliation: Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland; University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland.
authors.forename: Raili K
authors.initials: RK
authors.lastname: Salmelin
authors.affiliation: University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland; Pirkanmaa Hospital District, Science Center, PO Box 2000, FI-33521 Tampere, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Helminen
authors.affiliation: University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Tamminen
mesh_terms: D000328:Adult; D001290:Attitude; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D063189:Symptom Assessment / Q000523:psychology*; D055815:Young Adult
keywords: Depressive symptoms; EPDS; Maternal depression; Trajectory analysis