Older first-time mothers and early postpartum depression: a prospective cohort study of women conceiving spontaneously or with assisted reproductive technologies.

OBJECTIVE To evaluate whether older first-time mothers (≥37 years) have higher rates of postpartum depression compared with younger first-time mothers, controlling for mode of conception and known risk factors for postpartum depression. DESIGN Prospective cohort study. SETTING Assisted reproductive technology (ART) clinics in two large Australian cities and public and private antenatal clinics and/or classes in the vicinity of ART clinics. PATIENT(S) Nulliparous women who had conceived spontaneously (n = 295) or through ART (n = 297) in three age-groups: younger, 20 to 30 years (n = 173); middle, 31 to 36 years (n = 214); and older, ≥37 years (n = 189). INTERVENTION(S) Semistructured interviews and questionnaires. MAIN OUTCOME MEASURE(S) Major depressive disorder in the first 4 months after birth as assessed by structured diagnostic interview. RESULT(S) The study performed 592 complete pregnancy assessments and 541 postpartum assessments. The prevalence of major depressive disorder was 7.9%, at the lower end of community rates. Neither maternal age-group nor mode of conception was statistically significantly related to depression. CONCLUSION(S) Older first-time mothers, whether conceiving through ART or spontaneously, do not show increased vulnerability to postnatal depression.