Arch Womens Ment Health (2005) 8: 97–104 DOI 10.1007/s00737-005-0078-8 Original contribution Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample C. Rubertsson 1 , B. Wickberg 2 , P. Gustavsson 3 , and I. Ra ˚destad 1 1 Department of Caring and Public Sciences, M€ alardalen University, Sweden 2 Department of Psychology, University of G€ oteborg, Sweden 3 Department of Nursing, Karolinska Institutet, Stockholm, Sweden Received January 14, 2004; accepted November 28, 2004 Published online May 11, 2005 # Springer-Verlag 2005 Summary Background: Depression and other psychiatric disorders during preg- nancy and postpartum is an important health problem, especially if the symptoms are recurrent or sustained. Methods: All Swedish speaking women attending their first antena- tal care visit during three predestined weeks were invited to participate. Depressive symptoms were evaluated using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy, two months and one year postpartum. Results: In all, 2430 women completed three questionnaires. A dose-effect relation was found between the numbers of stressful life events experienced in the year prior to pregnancy and mean EPDS score in pregnancy. The prevalence of recurrent or sustained depressive symptoms (EPDS  12 on all three evaluations) was 3% (79=2430). Three factors were associated with depressive symptoms, two or more stressful life events in the year prior to pregnancy, native language other than Swedish and unemployment. Conclusions: Apart from questions about psychiatric history, a psy- chosocial history in early pregnancy including stressful life events, native language and employment status could help the health profes- sionals to identify women at risk for recurrent or sustained depression during pregnancy and the year after giving birth. Keywords: Depressive symptoms; postpartum depression; EPDS; risk factors; stressful life events. Introduction Depression is a major cause of disability in women and the first episode often takes place in the childbearing years (Weissman and Olfson, 1995) with onset during pregnancy or postpartum (Cox et al., 1993; O’Hara, 1986). Other psychiatric disorders occurring in the post- partum period might be postpartum psychoses, post- traumatic stress disorders, anxiety disorders, morbid preoccupations, eating disorders and obsessions of child harm (Brockington, 2004; Jones and Venis, 2001). Sev- eral investigators have found that antenatal depression is as common as postnatal depression (Evans et al., 2001; Green and Murray, 1994; Rubertsson et al., 2003). In a recent longitudinal study (Luoma et al., 2001), maternal depressive symptoms at any time, especially antenatally, were a risk factor for the child’s well being. Antenatal as well as recurrent maternal depressive symptoms were associated with the least favorable child outcome. Depression postpartum has also been associated with serious negative effects on the family (O’Hara, 1997) and the child’s wellbeing (Hammen and Brennan, 2003) especially if the depression is long-lasting or recurrent (Civic and Holt, 2000; Cogill et al., 1986; Cooper and Murray, 1997; Murray and Cooper, 1997). Moreover, depression is increasingly recognized as a disorder with risk for recurrent episodes followed by high levels of chronic stress and other difficulties for these women (Feske et al., 2001; Hammen, 2003). Few studies have however assessed depressive symptoms during the entire childbearing episode, from early pregnancy to one year after delivery (Austin and Lumley, 2003), and none in a national sample.