The role of premenstrual symptoms in the relationship between perceived social support and postnatal depression: an analysis of data from the Australian longitudinal study of women’s health

Background: Postnatal depression (PND) is a prevalent mental health condition which can have detrimental effects on people who gave birth and their children. People with pre-pregnancy pre-menstrual symptoms (PMS) are more vulnerable to developing PND and it is unclear whether social support may be a protective factor for these people. This study aims to investigate whether pre-pregnancy PMS alters the relationship between perceived social support in the six months postpartum and the likelihood of developing PND. Methods: This study included 832 primiparous participants from the Australian Longitudinal Study on Women's Health (ALSWH) 1973-78 and 1989-95 cohorts. PMS, social support and PND were measured using self-report surveys. Binary logistic regression analyses were conducted to explore the role of pre-pregnancy PMS by testing its interaction with social support in predicting PND likelihood. Results: 10.6% of participants reported PND and 57% reported experiencing pre-pregnancy PMS (43.0% never, 18.4% rarely, 25.7% sometimes, 12.9% often). Participants who reported more frequent pre-pregnancy PMS and had lower perceived social support in the six months post-partum, were more likely to be diagnosed with PND. We found no evidence that pre-pregnancy PMS alters the relationship between perceived social support and PND. Conclusions: This study reinforces the importance of identifying pre-pregnancy PMS as a significant risk factor for PND and highlights the role of perceived social support as a protective factor against PND. These findings support the potential value of interventions targeting social support for people at risk of PND, including those with pre-pregnancy PMS. Further research is needed to explore the effectiveness of increasing perceived social support in reducing PND in people with pre-pregnancy PMS.