Our names are Riddhi and Kristi, and we are researchers in Perinatal Psychiatry, interested in trying to improve mental health during and after pregnancy. In this piece, we are excited to present a new project we have been working on, called HappyMums. The goal of this project is to understand, predict, and treat depression in pregnancy, in order to improve mental health outcomes for both mothers and their offspring.
HappyMums is a research consortium, funded by the European Commission, bringing together research institutions and other organisations interested in perinatal mental health, from many countries across Europe, plus the United States.
Depression during pregnancy, also known as antenatal depression, is estimated to affect close to 30% of pregnant women and birthing people around the world. Some of its symptoms include low mood, sadness or being tearful, feelings of irritability and guilt, a loss of interest in daily life, an increase in negative thoughts, and feelings of hostility towards partners and/or babies.
It is especially important to treat antenatal depression, as it is associated with negative outcomes in both the mother and the baby. In the mother, for instance, it increases her risk of developing postnatal depression.
Numerous studies have also investigated the role of antenatal depression on offspring-related outcomes. Among newborn babies for example, untreated depression in pregnancy is associated with a lower birth weight, or being born preterm. These effects are also said to continue as the child grows, in the form of childhood depression and anxiety, and sleep problems in infancy and toddlerhood.
The outcomes associated with untreated antenatal depression highlight the need to examine the evidence base of treatments which include Cognitive Behaviour Therapy (CBT), yoga, mindfulness, Omega-3 supplementation, and bright light therapy, to name a few.
While depression in the perinatal period as a whole (the period of pregnancy up to the first year after birth) has been widely investigated for decades, a specific focus on antenatal depression is now emerging. However, there still remains a gap in the literature about the biological, and psychosocial, mechanisms underpinning antenatal depression, and what factors in a person’s life or environment might reduce or exacerbate their risk of developing depression during pregnancy or after birth.
Here at King’s College London, we are proud to be one of the partners involved in HappyMums, this important research project. Here’s more about what we hope to achieve:
Understand
The consortium comprises researchers who study perinatal mental health in many ways, and we hope that by coming together, we can build a broader understanding of pregnancy and mental health. For example, to study the role of the placenta, we have researchers who work with human volunteers who donate their placenta for research after birth, and this knowledge can be combined with that of other research teams, who study the placenta in different species of fish!
We believe that it is important that researchers who study a topic in different ways can combine and share their knowledge, to move our understanding forward more quickly.
Predict
So that we can better predict the development of antenatal depression, the consortium will also bring together a number of cohort studies (longitudinal research that follows participants over a number of years), which have recruited families from across Europe to collect data about pregnancy and the postnatal period, and what factors might be related to perinatal mental health. For example, these include pregnancy health, stressful life events and biological measurements of hormones and the immune system, as well as genetics.
By studying antenatal depression in so many participants, across many countries, we hope to gather understanding of which factors are most important in protecting someone from developing depression (for example good social support), and which can be most detrimental.
Treat
Following on from learning to predict antenatal depression in a more effective way, if we can do this, we can also become better at treating antenatal depression, by identifying it earlier, and by being able to target intervention and support to those who most need it.
One way we are doing this in HappyMums, is by developing a mobile app, which will be used to gather information from pregnant women who volunteer to be part of our pilot study.
We will use this information, after they have given birth, to build programmes capable of predicting who was most likely to develop antenatal depression. The study will be run across 6 countries in Europe (UK, Italy, Germany, Croatia, Poland, Finland), and will recruit over 1000 participants in total.
The app will also be used to gather information from volunteers in 3 ways:
asking volunteers to complete questionnaires about their mental health in the app;
giving volunteers access to game-like activities, which involve asking them to speak aloud, or type answers to daily questions, to see if information can be gained from the tone of someone’s voice, or the way they type on their phone;
by collecting information which is already passively collected in most smartphones, for example light sensors, step counters, and GPS locations.
As well as being used as a data collection tool, the app will also give users access to a “mum-to-be wellbeing course”, which will provide information about pregnancy and childbirth, curated by experts in the consortium. There will also be space in the app for users to monitor their own pregnancy and health.
We hope that we will learn more about if and how women would like this information to be used by their doctors or midwives to improve their care, and what information would be most helpful to provide to clinicians so that they can do make the best decisions for their patients.
As you can see, the HappyMums consortium is working hard to bring together many research groups to improve the experience of women during and after their pregnancy, and to support mental health during this very important time.
You can find out more about our progress on our website, www.happymums.eu, or by following us on Instagram and Twitter.
We will also be recruiting for our pilot study of the mobile app soon, so please feel free to email us at happymums@kcl.ac.uk if you would like more information.
