Conference Coverage

Maternal antepartum depression creates bevy of long-term risks in offspring

 

Key clinical point: Maternal depression during pregnancy can have far-reaching mental health consequences for the offspring.

Major finding: By midlife, offspring of an mother who had antepartum depression and a parent with a severe, hospital-treated mental disorder were at an adjusted 5.6-fold increased risk for psychotic depression and 7.8-fold greater risk of bipolar disorder than the offspring with neither risk factor.

Data source: The Northern Finland Birth Cohort 1966 is an ongoing, observational, prospective, general population-based study of the 12,058 individuals born in the two northernmost provinces of Finland during 1966.

Disclosures: The presenter reported having no financial conflicts of interest regarding the study, which is supported by the Academy of Finland, the Finnish Cultural Foundation Lapland Regional Fund, and grants from various nonprofit foundations.


 

AT THE ECNP CONGRESS

– Maternal depression during pregnancy is a common occurrence that can have far-reaching effects in the offspring, according to Tiina Taka-Eilola, MD, of the University of Oulu (Finland).

Indeed, maternal antepartum depression may best be thought of as an adverse environmental factor that exacerbates the impact of any underlying genetic vulnerability to severe mental disorder that may be present in the offspring, she said at the annual congress of the European College of Neuropsychopharmacology.

Dr. Tiina Taka-Eilola, University of Oulu (Finland) Bruce Jancin/Frontline Medical News
Dr. Tiina Taka-Eilola
She presented an analysis from Northern Finland Birth Cohort 1966 Study, an ongoing, observational, prospective, general population-based study of the 12,058 individuals born in the two northernmost provinces of Finland during 1966. Her study examined the relationship between maternal antepartum depression and the cumulative lifetime incidence of mood disorders in the offspring cohort aged 43 years. This, she added, is believed to be the only extant large, comprehensive study to track the mental health status into midlife of children whose mothers had antepartum depression.

At midgestation, back in the mid-1960s, 13.9% of the mothers of the Northern Finland Birth Cohort acknowledged feeling “depressed” or “very depressed,” rates consistent with those reported in other studies using standardized depression assessment instruments. Their offspring, by age 43 years, were 1.6-fold more likely to have a history of a current or past nonpsychotic mood disorder and 2-fold more likely to have had a psychotic mood disorder than did the offspring of mothers free of antepartum depression.

These risks were greatly amplified if either parent experienced a hospital-treated severe mental disorder before, during, or up to 18 years after the pregnancy. Offspring who had both a mother who experienced antepartum depression and a parent with a severe, hospital-treated mental disorder were at 3.9-fold increased risk for being diagnosed with nonpsychotic depression by age 43 years in an analysis adjusted for sex, perinatal complications, and other potential confounders. They also were at 5.6-fold increased risk for psychotic depression and a whopping 7.8-fold greater risk of bipolar disorder than offspring with neither risk factor.

Moreover, in an earlier study, among men in the Northern Finland cohort who were assessed at age 33 years, investigators found that maternal depression during pregnancy was associated with an adjusted 1.4-fold increased likelihood of having a criminal record for a nonviolent offense, a 1.6-fold increased risk of violent crime, and a 1.7-fold increase in violent recidivism. In contrast, women whose mothers were depressed during pregnancy didn’t have a significantly higher rate of criminality, compared with those whose mothers weren’t depressed (J Affect Disord. 2003 May;74[3]:273-8).

In another earlier analysis, Dr. Taka-Eilola’s senior coinvestigators demonstrated that the risk of schizophrenia in the Northern Finland offspring was 2.6-fold greater if there was parental psychosis but no maternal antepartum depression than if neither was present, while the risk was 9.4-fold higher when both risk factors were present (Am J Psychiatry. 2010 Jan;167[1]:70-7).

Dr. Taka-Eilola, a primary care physician, said that postpartum depression garners news headlines and is far more extensively researched than is antepartum depression, but as the Finnish data show, antepartum depression is at least as common and deserves to be taken seriously. It’s important to screen for it and to treat it in an effort to prevent adverse effects in the offspring, as well as out of concern for the mother’s well-being, she emphasized. She believes this is now more likely to happen as a consequence of a recent World Psychiatric Association report calling for greater clinician attention to perinatal mental health.

Dr. Taka-Eilola reported having no financial conflicts of interest regarding the Northern Finland Birth Cohort Study, which is supported by the Academy of Finland, the Finnish Cultural Foundation Lapland Regional Fund, and grants from various nonprofit foundations.

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