Single motherhood versus poor partner relationship: outcomes for antenatal mental health

Objective: In the transition to parenthood, lack of social support significantly impacts on maternal mood. This paper compares the influence of single-mother status and level of partner support in a partnered relationship, on antenatal emotional health. Methods: Antenatal demographic, psychosocial and mental health data, as determined by Edinburgh Postnatal Depression Scale (EPDS) score, were collected from 1578 women. The association between these variables, and marital status, was investigated using logistic regression. Results: Sixty-two women (3.9%) were identified as single/unpartnered. Elevated EPDS scores (> 12) were found in 15.2% (240/1578) of the total cohort and 25.8% (16/62) of the single/unpartnered women. EPDS scores were significantly lower for single/unpartnered women than for women with unsupportive partners (8.9 +/- 95.3 vs 11.9 +/- 6.5, p<0.001). Compared to the partnered cohort, single/unpartnered women were more likely to have experienced >= 2 weeks of depression before the current pregnancy (p<0.05), a previous psychopathology (p<0.001), emotional problems during the current pregnancy (p<0.01) and major life events in the last year (p<0.01). Binary logistic regression modelling to predict antenatal EPDS scores suggests that this is mediated by previous psychiatric history (p<0.001) and emotional problems during pregnancy (p = 0.02). Conclusion: Women in a partnered-relationship with poor partner-derived support were at an increased risk of elevated antenatal EPDS scores compared to single/unpartnered women. A previous history of depression and current emotional problems, rather than single mother status, were significant risk factors for elevated EPDS scores. The present study reiterates the contribution of psychosocial risk factors as important mediators of antenatal emotional health.