Interpregnancy interval and maternal postpartum depression and anxiety: findings from the APrON cohort.

Abstract

Shorter interpregnancy intervals (IPI) are linked to adverse maternal health outcomes, such as pre-eclampsia and gestational diabetes mellitus. The link between IPI and maternal mental health has not been examined despite its potential clinical implications. The aim of this study was to examine associations between IPI and postpartum symptoms of depression (PPD) and anxiety (PPA). We retrieved data from the APrON study. Mothers (n = 613) completed the Edinburgh Postpartum Depression Scale to assess depression and the Symptoms Checklist-90 to assess anxiety within 1 year of the second child's delivery. IPI was categorized into <6, 6-11, 12-17, 18-23, 24-59, and 60-119 months. Logistic generalized linear modeling was performed. Mothers ≥35 years of age had twice the odds of PPD (OR = 2.06, 95% CI: 1.25-3.36, P = .0041) compared to mothers <35 years. Mothers with high social support had 54% lower odds of PPD (OR = 0.46, 95% CI: 0.29-0.72, P = .00074) compared to mothers with low social support. Mothers with a history of PPD and/or PPA had 3× greater odds of PPD (OR = 3.00, 95% CI: 1.47-5.96, P = .0020) compared to those without a history. Social support postpartum and history of depression and/or anxiety were also associated with PPA (P < .05). IPI was not related to maternal PPD or PPA in this cohort. Comprehensive mental health support programs and resources are warranted not only postnatally, but prenatally and throughout gestation, particularly in older mothers and those with mental illness history.