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.