title: Antenatal Depressive Symptoms and Breastfeeding: A Prospective Cohort Study.
abstract: BACKGROUND
  Globally many women suffer from depression during pregnancy. This study investigated the impact of antenatal depressive symptoms on the duration of breastfeeding up to 6 months among women in Sabah, Malaysia.
  
  
  METHODS
  A prospective cohort study of 2,072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation and followed up at 1, 3, and 6 months postpartum. Depressive symptoms were assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale (EPDS). Cox regression analyses were performed to determine the relationship between antenatal EPDS scores and cessation of breastfeeding before 6 months postpartum.
  
  
  RESULTS
  In total, 1,078 (52%) women with complete information on breastfeeding duration were included in the final sample. Approximately 99% of mothers were breastfeeding at discharge, and 87% of them continued to breastfeed at 6 months postpartum. Women with an antenatal EPDS score of 8 or above were twice more likely to stop breastfeeding before 6 months (adjusted hazards ratio=1.95; 95% confidence interval, 1.26, 3.01) than those who scored less than 4 on the EPDS.
  
  
  CONCLUSIONS
  Depressive symptoms during pregnancy appeared to be associated with early breastfeeding cessation for mothers residing in Sabah.
authors.affiliation: 1 School of Medicine, University Malaysia Sabah , Kota Kinabalu, Sabah, Malaysia .
authors.forename: Aza Sherin Mohamad
authors.initials: AS
authors.lastname: Yusuff
authors.affiliation: 2 Department of Management Sciences, City University of Hong Kong , Kowloon, Hong Kong .|3 School of Public Health, Curtin University , Perth, Western Australia , Australia.
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.affiliation: 3 School of Public Health, Curtin University , Perth, Western Australia , Australia.
authors.forename: Colin W
authors.initials: CW
authors.lastname: Binns
authors.affiliation: 3 School of Public Health, Curtin University , Perth, Western Australia , Australia.
authors.forename: Andy H
authors.initials: AH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008296:Malaysia; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D037841:Pregnant People / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult