For many families, the joyous arrival of a new baby is overshadowed by an invisible struggle: postpartum depression. Although the term suggests it begins after childbirth, the reality of when and how maternal depression manifests has remained elusive.
It is vital for both mother and child that this knowledge gap be addressed, as doing so can shape public health policies that effectively support families during this crucial time, said Michelle Kee, a Principal Scientist at A*STAR Institute for Human Development and Potential (A*STAR IHDP), previously known as the Singapore Institute for Clinical Sciences (SICS).
“Previous studies, including those conducted in Singapore, have underscored the important role that maternal mood plays during pregnancy to influence a child’s neurodevelopmental outcomes,” Kee added.
Kee and Michael Meaney, Programme Director of Translational Neuroscience at A*STAR IHDP, collaborated with researchers from the National University of Singapore and KK Women’s and Children’s Hospital in Singapore; McGill University, University of Montreal and University of Calgary, Canada; and Yale School of Medicine, US; to launch a comprehensive multi-year study to gain deeper insights into postpartum depression.
The team recruited seven participant cohorts from Singapore, Canada and the UK to study the course and stability of depressive symptoms from pregnancy to two years post-childbirth across varied ethnic and geographic groups.
Participants underwent psychological tests and self-reported their depressive symptoms at various stages, from the beginning of pregnancy to two years after giving birth. The research team analysed this self-reported data, which was measured using well-established depression scales, applying advanced statistical methods such as item response theory and K-means clustering to categorise women with similar depressive symptom patterns.
Three distinct groups were identified: women with consistently low, mild and high levels of depressive symptoms. These patterns remained stable throughout the perinatal period for nearly all participants.
The study also found that variations in depressive levels frequently start during pregnancy and persist into the postpartum period. “Our findings contradict common misconceptions perpetuated by influential guidelines that maternal depression only manifests after childbirth,” Kee explained, noting that this challenges the suitability of the term 'postpartum depression'.
These observations corroborate clinical experiences of the early onset of maternal depressive symptoms, now supported by empirical data from Kee and colleagues. The researchers noted the need for more studies to confirm these results in other socioeconomic settings, particularly in low- and middle-income countries.
By determining the onset and trajectory of maternal depression, the researchers hope that their findings can refine public health guidelines, enabling mothers to recognise symptoms earlier and gain access to the necessary support.
Kee’s team is currently developing a preconception screening tool to identify individuals at risk for maternal mental health issues.
The A*STAR-affiliated researchers contributing to this research are from the A*STAR Institute for Human Development and Potential (A*STAR IHDP).
