Perinatal depression, defined as episodes of depression during or after pregnancy, can have long-term consequences for mothers and their children. More than half of women with perinatal depression are undiagnosed, with up to 85% receiving no treatment.

Emotional regulation is the ability to understand and manage emotional experiences, and is important for wellbeing, social interactions, and managing stress. It may be particularly important during and after pregnancy, when emotional regulation can be more difficult. Difficulties with emotional regulation have previously been linked to more depressive and anxiety symptoms during pregnancy and after birth.

However, it is not fully understood how the association between emotional regulation and depressive symptoms changes throughout pregnancy and after birth.

This edition of Tap into Research looks at a study that investigated the association between emotional regulation and depressive symptoms across the perinatal period, to explore whether assessing emotional regulation early in pregnancy could help identify women at risk of perinatal depression.

How were smartphones used in the study?

Participants in this study were from the Mom2B cohort, a prospective Swedish study using a smartphone app for data collection.

Participants completed online surveys through the app around 1-2 times per week at different stages of pregnancy and after birth. This included questions about:

• Emotional regulation: measured using a 16-item questionnaire called the DERS-16. This was completed at 16- 25 weeks of pregnancy and 17-25 weeks after birth.
• Depressive symptoms: measured after birth using a 10-item questionnaire asking about symptoms over the previous 7 days.
• Other factors that may be linked to emotional regulation and/or depressive symptoms: including the ability to recover from stress, the extent to which life feels manageable, and personality traits such as worry and obsessiveness.

What did the study find?

623 participants took part in the study. The main findings were:

• Emotional regulation remained relatively stable over the perinatal period, with no significant differences between 16-25 weeks of pregnancy and 17-25 weeks after birth.
• Difficulties in emotional regulation measured during the second trimester were associated with higher levels of perinatal depressive symptoms up to 14-23 weeks after birth.
• Women who experienced depression after birth had more difficulties regulating their emotions during pregnancy than women who did not experience perinatal depression. Difficulties with emotional regulation were greatest among women who experienced persistent depressive symptoms.

Why does this matter?

This study suggests that difficulties in emotional regulation during the second trimester of pregnancy may be an early indicator for depressive symptoms after birth. Assessing emotional regulation during pregnancy could therefore help identify women who may be at greater risk of developing depressive symptoms, allowing support to be offered earlier. Future research could explore how this screening could be used in clinical practice, and which groups of women would benefit most from these interventions.

Read the paper: Emotion regulation is robustly associated with perinatal depressive symptoms in a Swedish national cohort (Nature.com)

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