Psychosocial factors associated with trajectories of maternal psychological distress over a 10-year period from the first year postpartum: An Australian population-based study

Abstract

Maternal mental health problems contributes significantly to perinatal morbidities and extend beyond the perinatal period for some women. Drawing data from a population-based study this paper aimed to: 1) identify patterns of maternal psychological distress spanning ten years following the birth of a baby, and 2) identify psychosocial risk factors in the first postnatal year for trajectories of elevated psychological distress. A secondary analysis was conducted using data from 4875 mothers participating in the Longitudinal Study of Australian Children. The Kessler-6 assessed maternal psychological distress symptoms when the child was 0-12 months, 2-3 years, 4-5 years, 6-7 years, 8-9 years and 10-11 years. Longitudinal latent class analyses (LCA) was conducted to identify patterns of psychological distress. Latent class membership was assigned and used in subsequent regression analyses to identify predictors of each trajectory. LCA identified five distinct trajectories of maternal psychological distress symptoms over time. Predictors of trajectories with elevated symptoms reflected a pattern of social and economic disadvantage and psychosocial stress. The strongest predictors of elevated mental health symptoms were a history of depression [OR: 7.57(4.73-12.11)] and 3 or more stressful life events in the past year [OR: 3.38(2.02-5.65)]. The assessment of maternal mental health and child health was based on brief self-report measures and mothers from lower socioeconomic and diverse cultural backgrounds were underrepresented. These findings underscore the importance of early diagnosis and treatment of women at risk of mental health problems in the postnatal period and early years of parenting.