Links between perinatal risk factors and maternal psychological distress: A network analysis

Introduction: This paper explores a range of perinatal risk factors that may increase maternal vulnerability to postnatal psychological distress in a sample of 17531 women participating in the Millennium Cohort Study, a diverse British, longitudinal birth cohort study.
Materials and Methods: Using a graphical network modelling framework, this study models links between postnatal psychological distress and perinatal risk factors while controlling for socio-demographic factors and history of depression and anxiety. Postnatal psychological distress was assessed at nine-months post-partum using the Rutter Malaise Inventory.
Results: Results of the graphical network models indicate that lower levels of happiness about the pregnancy (Edge weight (w)=0.084, CI=0.069 to 0.100, b=0.095), smoking during pregnancy (w=0.026, CI=-0.009 to 0.060, b=0.029), infection during pregnancy (w=0.071, CI=0.024 to 0.118, b=0.090), hyperemesis gravidarum (w=0.068, CI=0.013 to 0.123, b=0.083), baby in special care (w=0.048, CI=-0.004 to 0.099, b=0.062), not being White (w=0.101, CI=0.062 to 0.140, b=0.118), being from a more deprived area (w=-0.028, CI=-0.051 to -0.005, b=-0.039), lower income (w=-0.025, CI=-0.055 to 0.005, b=-0.036) and history of depression or anxiety (w=0.574, CI=0.545 to 0.603, b=0.764) are associated with increased psychological distress.
Conclusion: While some perinatal risk factors may be directly associated with postnatal psychological distress, many risk factors appear to be primarily associated with demographic factors. This emphasizes the importance of taking a holistic approach when evaluating an individual’s risk of developing postnatal psychological distress.