Perinatal mental health: how nordic data sources have contributed to existing evidence and future avenues to explore

Abstract

Purpose

Perinatal mental health disorders affect a significant number of women with debilitating and potentially life-threatening consequences. Researchers in Nordic countries have access to high quality, population-based data sources and the possibility to link data, and are thus uniquely positioned to fill current evidence gaps. We aimed to review how Nordic studies have contributed to existing evidence on perinatal mental health.

Methods

We summarized examples of published evidence on perinatal mental health derived from large population-based longitudinal and register-based data from Denmark, Finland, Iceland, Norway and Sweden.

Results

Nordic datasets, such as the Danish National Birth Cohort, the FinnBrain Birth Cohort Study, the Icelandic SAGA cohort, the Norwegian MoBa and ABC studies, as well as the Swedish BASIC and Mom2B studies facilitate the study of prevalence of perinatal mental disorders, and further provide opportunity to prospectively test etiological hypotheses, yielding comprehensive suggestions about the underlying causal mechanisms. The large sample size, extensive follow-up, multiple measurement points, large geographic coverage, biological sampling and the possibility to link data to national registries renders them unique. The use of novel approaches, such as the digital phenotyping data in the novel application-based Mom2B cohort recording even voice qualities and digital phenotyping, or the Danish study design paralleling a natural experiment are considered strengths of such research.

Conclusions

Nordic data sources have contributed substantially to the existing evidence, and can guide future work focused on the study of background, genetic and environmental factors to ultimately define vulnerable groups at risk for psychiatric disorders following childbirth.

Keywords:

• Perinatal mental health
• Nordic countries
• longitudinal dataset
• national registers

Acknowledgments

The authors sincerely thank all women who participated in the individual Nordic studies. We would also like to express our gratitude to all personnel for their valuable help in the data collection and administration of the studies.

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

No fund was received for the present review study.

Notes on contributors

Maria A. Karalexi

Maria Karalexi, MD, Pediatrician and PhD graduate from the Department of Epidemiology, Athens University, Greece. She has been working as Postdoctoral Fellow at the Department of Epidemiology, Ioannina University, Greece and currently as Research Associate at the Department of Women’s and Children’s Health, Uppsala University, Sweden on different projects within peripartum mental health.

Malin Eberhard-Gran

Malin Eberhard-Gran, MD, Professor of Clinical Epidemiology and Health Services Research at the Institute of Clinical Medicine of the University of Oslo, Norway and past-president of the Nordic Marcé Society for Perinatal Mental Health. Affiliated with the Norwegian Institute of Public Health for 20 years, she is currently senior researcher at the Norwegian Research Centre for Women’s Health, Oslo University Hospital, Rikshospitalet, Norway. Her research activities have been primarily within the fields of reproductive epidemiology and psychometrics.

Unnur Anna Valdimarsdóttir

Unnur Anna Valdimarsdóttir, Professor of Epidemiology at the University of Iceland, and Adjunct Professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet and Department of Epidemiology, Harvard TH Chan School of Public Health. PhD from Karolinska Institutet (2003). Her research focuses on the impact of trauma and stressful life events on health and was awarded a consolidator grant from the European Research Council (2017).

Hasse Karlsson

Hasse Karlsson, MA, MD, PhD, Professor of Integrative Neuroscience and Psychiatry, University of Turku. Chief Physician, Hospital District of Southwest Finland, Department of Psychiatry. Director, Turku Brain and Mind Center.

Trine Munk-Olsen

Trine Munk-Olsen, Professor of Psychiatry at University of Southern Denmark with expertise in epidemiology (psychiatric, reproductive and pharmacoepidemiology). Her work relies mostly on data from Danish population registers and she has focused mainly on women’s mental health across pregnancy and postpartum, including postpartum depression and psychosis.

Alkistis Skalkidou

Alkistis Skalkidou, Professor of Obstetrics and Gynecology, Uppsala University, Sweden and president of the Nordic Marcé Society for Perinatal Mental Health. Her research focuses on peripartum mental health and its effects on children using sizable population-based cohorts and register data. She also contributes to the European Union COST-Action Rise UP-PPD.