Obstetrical complications and the development of postpartum depressive symptoms: a prospective survey of the MATQUID cohort

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Abstract
Objective: To prospectively investigate in a cohort of pregnant women the association between obstetrical complications (OCs) and depressive symptomatology in the early postpartum period. Method: A total of 441 pregnant women attending the State Maternity Hospital in Bordeaux were interviewed during the third trimester of pregnancy, then at 3 days and 6 weeks after birth. Maternal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on a large range of pregnancy, delivery and neonatal somatic adverse events were collected by interviewing the mothers. Data on OCs were rated using the McNeil-Sjostrom scale for OCs. A dimensional definition of postnatal depression (EPDS summary score 6 weeks after delivery) was used to explore the relationships between OCs and early postnatal depressive symptoms. Results: Exposure to severe OCs during pregnancy was associated with more intense depressive symptoms in the early postnatal period, independently from demographic characteristics, marital adjustment, parity, and a history of depressive or anxiety disorder during pregnancy (adjusted B=0.16, 95% CI 0.007, 0.30, P=0.04). No association was found between the severity of postnatal depressive symptoms and labour/delivery or neonatal complications. Conclusion: Severe pregnancy complications may increase the severity of postnatal depressive symptoms by acting as acute or chronic stressors during pregnancy. The links between OCs, maternal psychopathology, and child development, need to be explored further.