Maternal Depression
A trained psychologist administered the validated Spanish version19, 20 of the Edinburgh Depression Scale questionnaire (EDS) during the second or third trimester of pregnancy (prenatal period), and the 1, 6, 12, 18, 24, and 48 month postnatal study visits. The 10-item EDS asks about depression symptoms in the past 7 days, including: “1: I have laughed and been able to see the funny side of things,” “2: I have looked forward with enjoyment to things,” “3: I have blamed myself unnecessarily when things went wrong,” “4: I have been anxious or worried for no good reason,” “5: I have felt scared or panicky for no very good reason,” “6: Things have been getting on top of me,” “7: I have been so unhappy that I have had difficulty sleeping,” “8: I have felt sad or miserable,” “9: I have been so unhappy that I have been crying,” and “10: The thought of harming myself has occurred to me.” Participants rated the severity or frequency of each item based on 4 levels scored from 0 (indicating the most favorable condition) to 4 (indicating the least favorable condition) for each item. Total scores can range from 0 to 30.
Maternal depression were examined as a dichotomous outcome using EDS scores at a clinically-relevant cutoff (EDS score > 12)21. Maternal depression was examined at three time specific categories: a) depression only during pregnancy, b) postpartum depression, and c) recurrent depression. Depression during pregnancy was defined as depression during the second or third trimester of pregnancy and at no other subsequent time point. Postpartum depression was defined as depression during the first or sixth month postpartum. Lastly, recurrent depression was defined as postpartum depression and depression at any subsequent time point postnatally.