Antenatal depressive symptoms are strongly predicted by the severity of pre-menstrual syndrome: results of partial least squares analysis

AbstractObjectiveAntenatal depression (AD) is the commonest morbidity during pregnancy. There is evidence that premenstrual syndrome (PMS) and AD share common immune-inflammatory pathways. Few studies have assessed the relation between the affective symptoms of PMS and AD. The present study aims to evaluate the association between the severity of depressive PMS and AD in early and late pregnancy.MethodsWomen in early pregnancy (<=16 weeks) were recruited and followed until late pregnancy (>=20 weeks). The Premenstrual Symptoms Screening Tool (PSST) was used to assess PMS and AD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Results: The PSST score was significantly and positively associated with the EPDS scores both in early and late pregnancy. Up to 57.6% of the variance in the early EPDS score was explained by the regression on the first factor extracted from 10 depression and anxiety PSST items (dubbed the DepAnx PSST domain), PSST item insomnia, relation dissatisfaction, and the Abuse Assessment Screen item 1 (partner abuse). Additionally, 6.3% of the variance in the PSST DepAnx domain was explained by the regression on the mental-physical neglect score of the Adverse Childhood Experiences Questionnaire. There were specific indirect effects of PSST DepAnx (p<0.001), insomnia (p=0.041), relation dissatisfaction (p=0.023) and partner abuse (p=0.007) on the late EPDS which were mediated by the early EPDS score.ConclusionThe affective, but not psychosomatic, symptoms of PMS strongly predict depressive symptoms during pregnancy suggesting that the pathophysiology of affective PMS symptoms overlap with those of AD.