TY - JOUR
T1 - A systematic review of growth curve mixture modelling literature investigating trajectories of perinatal depressive symptoms and associated risk factors
AU - Baron, Emily
AU - Bass, Judith
AU - Murray, Sarah M.
AU - Schneider, Marguerite
AU - Lund, Crick
N1 - Funding Information:
This work was supported by the National Institute of Mental Health of the National Institutes of Health [grant number U19MH095699] and by the National Institute of Mental Health Global Mental Health training grant [grant number MH103210 to S.M.M.]. The funders did not have any role in the study design, data collection, analysis or interpretation of the data, or in the writing of the report.
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Background The aim of this study was to review the growth curve mixture modelling (GCMM) literature investigating trajectories of perinatal maternal depressive symptoms and associated risk factors. Methods A systematic search of peer-reviewed articles published until November 2015 was conducted in seven databases. Articles using GCMM to identify trajectories of perinatal depressive symptoms were considered. Symptoms had to be assessed at least three times, anytime from pregnancy to two years postpartum (PROSPERO; 2016:CRD42016032600). Results Eleven studies met inclusion criteria. All reported a low risk trajectory, characterised by stable low depressive symptoms throughout the perinatal period. A stable moderate-high or high symptom trajectory was reported in eight of 11 studies, suggesting a high-risk group with persistent depressive symptoms. Six studies also reported transient trajectories, with either increasing, decreasing or episodic depressive symptoms. None of the demographic, personality or clinical characteristics investigated systematically differentiated groups of women with different symptom trajectories, within or across studies. Thus, it is difficult to differentiate women at high or low risk of specific perinatal depression trajectories. Limitations A meta-analysis was not possible. The studies’ settings and inclusion criteria limit the generalisability of the findings to low-risk, middle- to high-income women. Conclusions Relatively similar trajectories of perinatal depressive symptoms were identified across studies. Evidence on factors differentiating women assigned to different trajectories was inconsistent. Research with larger samples and in more diverse settings is needed to inform services and policies on how and when to effectively identify subgroups of women at high risk of perinatal depression.
AB - Background The aim of this study was to review the growth curve mixture modelling (GCMM) literature investigating trajectories of perinatal maternal depressive symptoms and associated risk factors. Methods A systematic search of peer-reviewed articles published until November 2015 was conducted in seven databases. Articles using GCMM to identify trajectories of perinatal depressive symptoms were considered. Symptoms had to be assessed at least three times, anytime from pregnancy to two years postpartum (PROSPERO; 2016:CRD42016032600). Results Eleven studies met inclusion criteria. All reported a low risk trajectory, characterised by stable low depressive symptoms throughout the perinatal period. A stable moderate-high or high symptom trajectory was reported in eight of 11 studies, suggesting a high-risk group with persistent depressive symptoms. Six studies also reported transient trajectories, with either increasing, decreasing or episodic depressive symptoms. None of the demographic, personality or clinical characteristics investigated systematically differentiated groups of women with different symptom trajectories, within or across studies. Thus, it is difficult to differentiate women at high or low risk of specific perinatal depression trajectories. Limitations A meta-analysis was not possible. The studies’ settings and inclusion criteria limit the generalisability of the findings to low-risk, middle- to high-income women. Conclusions Relatively similar trajectories of perinatal depressive symptoms were identified across studies. Evidence on factors differentiating women assigned to different trajectories was inconsistent. Research with larger samples and in more diverse settings is needed to inform services and policies on how and when to effectively identify subgroups of women at high risk of perinatal depression.
KW - Depressive symptoms
KW - Growth mixture modelling
KW - Postpartum
KW - Pregnancy
KW - Risk factors
KW - Trajectory
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U2 - 10.1016/j.jad.2017.07.046
DO - 10.1016/j.jad.2017.07.046
M3 - Review article
C2 - 28763638
AN - SCOPUS:85026420883
SN - 0165-0327
VL - 223
SP - 194
EP - 208
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -