What question did this study set out to answer?

The study aims to investigate the long-term effects of postpartum depressive symptoms on anxiety and depression in women over 15 years.

March 18, 2026Open Access

Postpartum Depressive Symptoms and Their Long-Term Association with Anxiety and Depression in Women: Findings from the Rhea Study in Crete, Greece

Key Points

The study aims to investigate the long-term effects of postpartum depressive symptoms on anxiety and depression in women over 15 years.
Analyzed data from the Rhea Mother-Child Cohort in Crete, Greece.
Used the Edinburgh Postnatal Depression Scale (EPDS) for postpartum assessments.
Conducted follow-up assessments at 11 and 15 years using the STAI-Trait and BDI measures.
Applied multivariable linear mixed-effects models to evaluate associations, controlling for various factors.
Higher postpartum EPDS scores correlated with increased anxiety and depression symptoms at follow-ups.
Significant associations persisted after adjusting for demographic and psychosocial factors.
The relationship with anxiety symptoms strengthened over time, particularly noticeable at the 15-year follow-up.

Abstract

Background/Objectives: Postpartum depression affects 10–20% of women and may have long-term consequences for mental health. This study examines the association between postpartum depressive symptoms and women’s depression and anxiety symptoms 11 and 15 years after childbirth. Methods: Data were drawn from the Rhea Mother–Child Cohort in Crete, Greece. A total of 1079 women completed the Edinburgh Postnatal Depression Scale (EPDS) at approximately 8–10 weeks postpartum. Of these, 516 participated in follow-up assessments at 11 and 15 years, which included measures of anxiety (State-Trait Anxiety Inventory, Trait version STAI-Trait) and depressive symptoms (Beck Depression Inventory BDI). Multivariable linear mixed-effects models were used to assess the relationship between postpartum depressive symptoms (EPDS) and later anxiety (STAI-Trait) and depression (BDI) outcomes, adjusting for sociodemographic and family-related characteristics and psychosocial factors. Results: Higher postpartum EPDS scores were associated with greater anxiety (STAI-Trait) and depressive symptoms (BDI) across follow-up assessments. Associations remained significant after adjusting for maternal baseline characteristics and follow-up factors. An interaction with time suggested that the association between postpartum depressive symptoms and anxiety levels strengthened over time, with a stronger association at the 15-year follow-up, indicating a higher long-term mental health burden. Conclusions: Postpartum depressive symptoms are associated with higher levels of depressive and anxiety symptoms 11 and 15 years after childbirth. The association with depression appeared relatively consistent across follow-up assessments, while the relationship with anxiety was stronger at the 15-year follow-up. These findings suggest that postpartum depression is an early marker of long-term vulnerability to mood and anxiety disorders, highlighting the importance of early screening, intervention, and long-term mental health support for mothers to reduce the risk of enduring psychological difficulties.

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Cite This Study

Koutra et al. (Mon,) studied this question.

synapsesocial.com/papers/69ba421b4e9516ffd37a202f https://doi.org/https://doi.org/10.3390/healthcare14060745

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