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Prenatal Psychological Distress and Access to Mental Health Care in the ELFE Cohort

Published online by Cambridge University Press:  15 April 2020

M. Bales
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France
E. Pambrun
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France
M. Melchior
INSERM, UMRS 1136 Pierre-Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Paris, France Sorbonne University, UPMC Paris University, Paris, France
N.M.-C. Glangeaud-Freudenthal
INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris Descartes University, Paris, France
M.-A. Charles
Ined Inserm joint unit Elfe, Paris, France
H. Verdoux
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France University Department of Adult Psychiatry, Charles-Perrens Hospital, Bordeaux, France
A.-L. Sutter-Dallay*
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France University Department of Adult Psychiatry, Charles-Perrens Hospital, Bordeaux, France
*Corresponding author at: Pôle Universitaire Psychiatrie Adulte, Centre Hospitalier Charles-Perrens, 121, rue de la Bé chade, 33076 Bordeaux Cedex, France. Tel.: +33 5 56 56 17 82; fax: +33 5 56 56 35 15. E-mail (A.-L. Sutter-Dallay).
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Pregnant women are vulnerable to the deleterious impact of environmental stressors. The aims were to identify the environmental and pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care.


We used data from the French cohort Étude Longitudinale Française depuis l’Enfance (ELFE), a nationally representative cohort of children followed-up from birth to adulthood. Information about prenatal psychological status and access to mental health care was collected during the maternity stay. Maternal/pregnancy characteristics independently associated with psychological distress and access to mental health care were explored using multivariate analyses.


Of the 15,143 mothers included, 12.6% reported prenatal psychological distress. Prenatal distress was more frequent in women with very low economical status, alcohol/tobacco use, unplanned/unwanted pregnancy, late pregnancy declaration, multiparity and complicated pregnancy (high number of prenatal visits, prenatal diagnosis examination, obstetrical complications). Of the women reporting prenatal distress, 25% had a prenatal consultation with a mental health specialist and 11% used psychotropic drugs during pregnancy. Decreased likelihood to consult a mental health specialist was found in young women, with intermediate educational level and born abroad.


Causal inferences should be made cautiously as the questionnaire did not collect information on the temporal sequence between psychological distress and associated characteristics.


Women with social and obstetrical vulnerabilities are at increased risk of poor mental health during pregnancy. Improving mental health care access during pregnancy is a public health priority.

Original article
Copyright © Elsevier Masson SAS 2014

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