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      The courses of maternal and paternal depressive and anxiety symptoms during the prenatal period in the FinnBrain Birth Cohort study

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          Abstract

          Maternal prenatal symptoms of depression and anxiety have been suggested to impose differential effects on later offspring development, depending on their characteristics, such as timing, intensity and persistence. Paternal symptoms have been less investigated. While knowledge on these trajectory characteristics is essential for improved comprehension of prenatal stress, prospective studies including both expecting parents have been scarce. We aim at identifying and comparing the trajectories of prenatal depressive and anxiety symptoms in both parents in a pregnancy cohort design. The sample included 3202 mothers and 2076 fathers who were recruited to the FinnBrain Birth Cohort study ( www.finnbrain.fi). Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and general anxiety by the anxiety scale of the Symptom Checklist -90 (SCL-90) repeatedly at 14, 24, and 34 gestational weeks. Five differential depressive and four anxiety symptom trajectories were identified across pregnancy both in mothers and in fathers. The trajectories of consistently low depressive or anxiety symptoms were associated with higher educational level in both parents, and with nulliparity and non-smoking during pregnancy in mothers. Parents with consistently high or increasing levels of symptoms had more often prenatal SSRI medication. The congruences between elevated depressive and anxiety symptoms at any point in pregnancy, as well as parental trajectories within families were low. However, in this population-based sample, the self-reported symptom levels of both parents were generally very low. Variance in timing and persistence of parent-reported prenatal depressive and anxiety symptoms is potentially important, while symptom trajectories are very similar in mothers and fathers. These differential symptom trajectories and the significance of their correlates should be acknowledged when studying prenatal stress exposures and the related outcomes in children.

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            SCL-90: an outpatient psychiatric rating scale--preliminary report.

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              Growth Mixture Modeling: A Method for Identifying Differences in Longitudinal Change Among Unobserved Groups.

              Growth mixture modeling (GMM) is a method for identifying multiple unobserved sub-populations, describing longitudinal change within each unobserved sub-population, and examining differences in change among unobserved sub-populations. We provide a practical primer that may be useful for researchers beginning to incorporate GMM analysis into their research. We briefly review basic elements of the standard latent basis growth curve model, introduce GMM as an extension of multiple-group growth modeling, and describe a four-step approach to conducting a GMM analysis. Example data from a cortisol stress-response paradigm are used to illustrate the suggested procedures.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Writing – original draft
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: Formal analysisRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Project administrationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 December 2018
                2018
                : 13
                : 12
                : e0207856
                Affiliations
                [1 ] University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
                [2 ] University of Turku, Department of Psychology, Turku, Finland
                [3 ] University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
                [4 ] University of Turku, Department of Teacher Education, Turku, Finland
                [5 ] Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
                [6 ] University of Turku and Turku University Hospital, Institute of Clinical Medicine, Department of Child Psychiatry, Turku, Finland
                Chiba Daigaku, JAPAN
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-6833-1565
                http://orcid.org/0000-0002-4725-0176
                Article
                PONE-D-18-08636
                10.1371/journal.pone.0207856
                6296666
                30557345
                18bd9ad5-1dd1-4858-88ac-0fbfec4c447f
                © 2018 Korja et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 21 March 2018
                : 7 November 2018
                Page count
                Figures: 4, Tables: 9, Pages: 19
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100005875, Kulttuurin ja Yhteiskunnan Tutkimuksen Toimikunta;
                Award Recipient :
                This study is funded by the Academy of Finland (129839, 134950, 253270, 286829, 287908, 308176, 308252), Emil Aaltonen Foundation, Finnish Medical Association, Jane and Aatos Erkko Foundation, Signe and Ane Gyllenberg Foundation, State Grants for Clinical Research (ERVA) and Yrjö Jahnsson Foundation.
                Categories
                Research Article
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                People and Places
                Population Groupings
                Families
                Mothers
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                People and Places
                Population Groupings
                Families
                Fathers
                Social Sciences
                Sociology
                Education
                Educational Attainment
                Research and Analysis Methods
                Research Design
                Cohort Studies
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Custom metadata
                We have a strict legal rules in terms of data sharing in the medical faculty at the University of Turku. The anonymized dataset is available upon request. The requests of data can be pointed to statistician Juho Pelto ( juho.pelto@ 123456utu.fi ).

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