Post-natal depression and smoking cessation before, during and after pregnancy

Background: A substantial proportion of women give up smoking before, during and after pregnancy. It is estimated that between 7% to 17% of post-partum women may experience depression, with a higher risk among those women with a history of clinical depression. However, little is known about the relationship between maternal mental health and smoking cessation. Our longitudinal study explores whether post-natal depression is related to changes in patterns of tobacco consumption before, during and after the pregnancy.

Method: Each participant was assessed for symptoms of depression at the first clinic visit (entry to the study), and reassessed at various intervals – at 3-5 days, at 6 months, and again at 5 years after the birth of the child-using the DSSI-D( Delusions-Symptoms- States Inventory/ Bedford and Foulds, 1976). Smoking was also assessed at each stage of data collection and there was a retrospective report of smoking prior to the pregnancy.

Results: There is a linear association between tobacco consumption in pregnancy and the proportion of women who experience anxiety and depression in the postnatal period. The test for the two main causal pathways, smoking leading to depression and depression leading to smoking suggests that prior poor mental health (anxiety/depression) precede smoking behavior and the changes in smoking do not impact on maternal mental health.

Conclusion: The analysis examines whether post-natal depression contributes to smoking behavior/relapse or whether smoking cessation leads to worsening of pre-existing poor mental health and subsequent post natal depression in women. Poor mental health predicts patterns of smoking behavior but the reverse is not the case.

Dr Divey Rattan
School of Population Health, University of Queensland

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