Prevalence of Prenatal Depression Symptoms Among 2 Generations of Pregnant Mothers: The Avon Longitudinal Study of Parents and Children

Importance: Depression during pregnancy (antenatal depression) is common and has important consequences for mother and child. Evidence suggests an increasing prevalence of depression, especially in young women. It is unknown whether this is reflected in an increasing prevalence of antenatal depression. Objective: To compare the prevalence of depression during pregnancy in today’s young mothers with their mothers’ generation. Design: A two generation longitudinal study. Setting: We compared antenatal depressive symptoms in two generations of the Avon Longitudinal Study of Parents and Children (ALSPAC-G0 and ALSPAC-G1). Participants: In this analysis, ALSPAC-G0 participants are the original mothers (recruited when they were pregnant). ALSPAC-G1 are female offspring participants, or female partners of male offspring participants, who become pregnant. We limited both groups to the same age range (age 19-24). ALSPAC-G0 pregnancies occurred in 1990-92 (n=2,390) and ALSPAC-G1 in 2012-16 (n=180). In both generations women were born in the same geographical area (South West England). Exposures: Depressed mood measured antenatally using the Edinburgh Postnatal Depression Scale (EPDS) in self-reported surveys in both generations, taking a cut off >12 (scores range from 0-30). Results: 408 (17%) pregnant women in G0 and 45 (26%) in G1, had high depressive symptom scores (>12). Having high depressive symptom scores (>12) was 51% more common in the current generation of young pregnant women (2012-16), than in their mother’s generation in 1990-92 (RR 1.51 [95%CI: 1.15, 1.97] ), with imputation for missing confounding variable data and adjustment for age, parity, education, smoking, or BMI not substantially changing this difference. Results were essentially the same when analyses were restricted to the 66 mother-offspring pairs. Maternal antenatal depression (G0) was associated with daughter's (G1) antenatal depression (RR 3.33 [1.65 to 6.67]) Conclusion: In this unique study of two generations of women who answered identical questionnaires in pregnancy, we find evidence that depressed mood may be higher in young pregnant women today than in their mothers’ generation 25 years ago. Due to the multiple and diverse consequences of antenatal depression, an increase in prevalence has important implications for families, health care professionals and society. Keywords: ALSPAC; ALSPAC-G2; Antenatal; Depression; Intergeneration