Unlike postpartum depression, antenatal depression has not been studied well. There are no studies that have followed these women to determine how long the depression lasts, its severity and what the relapse rates are. So far, most studies have only identified depressed pregnant women based on their symptoms, but the chronology of depression has not been studied well.
The criteria for making a diagnosis of depression in pregnancy are the same as in the non-pregnant state. However, making a diagnosis of depression in pregnancy is somewhat difficult. Many women develop fatigue, sleeping difficulties, change in weight and appetite during a normal pregnancy, and these symptoms cannot automatically all be ascribed to depression.
Given this dilemma in making a firm diagnosis, screening tools have been developed to help physicians in indentifying women with clinical depression. The Edinburgh Postnatal Depression Scale has been endorsed for use, screening not only postpartum depression but also depression during pregnancy.
Some of the factors that increase risk of depression during pregnancy include:
- prior history of depression
- prior history of premenstrual dysphoric disorder
- younger age
- limited social support
- living alone
- greater number of children
- marital conflict
- ambivalence about pregnancy
A history of depression during the antenatal phase is considered to be the strongest predictor of depression during any following pregnancy and during the early postpartum period.