Maternal perinatal depression: heterogeneity and multiple trajectories across time.

Introduction: Perinatal depression has been widely studied since many years, with lot of evidence about its prevalence, risk factors and consequences for child development (Goodman, 2019). Compared to the past scientific literature characterizing past years (2000-2010) and emphasizing the existence of “a perinatal depression”, recent empirical evidence recognizes the existence of “many perinatal depressions” and suggests the need to better identify the heterogeneity of depressive symptoms (Baron et al., 2017; Boekhorst et al., 2019). The study aims, therefore, at confirming the existence of multiple trajectories in the perinatal period. Methods: A literature search was realized among the main databases in the last 4 years (2015-2019), using the keywords: perinatal depression, perinatal depressive symptoms, mothers, women, trajectories, course, longitudinal. No specific systematic or meta-analyses reviews were conducted. Relevant articles were selected, based on the content, sample size and statistical analyses. Besides, specific data on perinatal depression trajectories from the authors’ studies were selected for the aims of this study. Results: Ten selected articles showed the possibility to recognize at least 3 different trajectories (women always depressed; women depressed at onset, but then recovering; women getting depressed only later) of depression across the postnatal period, up to 24 months. Main results from the authors’ studies also confirmed multiple trajectories for depressive symptoms in a time range of 12 postpartum months, both for mothers of full-term and preterm babies. Conclusions: Consistent findings emerge on the existence of different and evident trajectoris regarding the course of depressive symptoms in mothers, at least across the first postnatal year. Despite this, a huge part of the literature on perinatal psychopathology still neglects this evidence, with the risk of underestimating the impact of the chronicity of depression on infant outcomes.