Prevalence and trends of moderate-to-severe depression during antenatal and two-year postpartum periods: A secondary data analysis from NHANES 2007-2018.

Objective: To investigate the prevalence and trend in depression during antenatal and two-year postpartum periods in the USA.

Methods: Using the data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, 1099 adult pregnant women and women within 24 months postpartum were included. The depression status was defined as having a patient health questionnaire (PHQ-9) score.

Results: The estimated prevalence of overall and moderate-to-severe depressive symptoms was 29.7% (95% confidence interval [CI]: 26.1%-33.3%) and 13.7% (95% CI: 11.1%-16.2%), respectively, which did not change apparently from 2007 to 2018. Stratified analyses confirmed a substantial upward trend in the prevalence of moderate-to-severe depressive symptoms among women aged 26-35 years, from 7.5% (95% CI: 1.2%-13.8%) in 2007-2008 to 17.2% (95% CI: 7.7%-26.7%) in 2017-2018 (P for trend = 0.019), with a 5.7% relative increase (95% CI: 1.5%-10.2%) per two-year cycle. In the whole population, the prevalence of moderate-to-severe depressive symptoms was 10.4% (95% CI: 6.6%-14.1%) in pregnancy, 13.9% (95% CI: 9.7-18.0) in the first year postpartum, to 16.8% (95% CI: 11.3%-22.3%) in the second year postpartum, P for trend = 0.047. In maternal women with depressive symptoms, 36.1% (95% CI: 25.0%-47.1%) had moderate-to-severe type in pregnancy, 47.7% (37.2%-58.1%) in the first year postpartum, and 53.1% (95% CI: 43.4%-62.9%) in the second year postpartum, P for trend = 0.038.

Conclusion: In general, the prevalence of moderate-to-severe depressive symptoms has remained relatively stable during 2007-2018, but it still tended to be severe in certain subgroups of the population and deserves more concern.