The risk factors for postpartum depression: A population-based study

Abstract

Background Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Only a few large population based studies of PPD have used clinical diagnoses of depression and no study has examined how a maternal depression history interacts with known risk factors. The objective of the study was to examine the impact of a depression history on PPD and pre- and perinatal risk factors. Method Nationwide prospective cohort study of all women with live singleton births in Sweden from 1997 through 2008. Relative risk of clinical depression within the first year postpartum and two-sided 95% confidence intervals. Results The relative risk of PPD in women with a history of depression was estimated at 21.03 (confidence interval: 19.72–22.42), compared to those without. Among all women, PPD risk increased with advanced age (1.25[1.13–1.37]) and with gestational diabetes (1.70[1.36–2.13]). Among women with a history of depression, pre-gestational diabetes (1.49[1.01–2.21]) and mild preterm delivery also increased risk (1.20[1.06–1.36]). Among women with no depression history, young age (2.14 [1.79–2.57]), those undergoing instrument assisted (1.23[1.09–1.38]) or cesarean (1.64[1.07–2.50]) delivery and moderate preterm delivery increased risk (1.36[1.05–1.75]). Rates of PPD decreased considerably after the first postpartum month (relative risk = 0.27). Conclusion In the largest population based study to date, the risk of PPD was more than 20 times higher for women with a depression history, compared to women without. Gestational diabetes was independently associated with a modestly increased PPD risk. Maternal depression history also had a modifying effect on pre- and perinatal PPD risk factors.

Profiles and characteristics of clinical subtypes of perinatal depressive symptoms: A latent class analysis

“…For instance presence in Class 2 (the severe depressive symptoms group) compared with the other classes was relatively likely for younger postpartum women, with low levels of education, a history of abortion and perinatal complications. Consistent with previous studies (Silverman et al, 2017), among women with no depression history, younger age was associated with increased risk of depressive symptoms, even though the young women were generally prepared for their forthcoming delivery. However, because of their youth and the frightening delivery experience, young women are relatively likely to experience severe depression (Jairaj et al, 2018;Melville, Gavin, Guo, Fan, & Katon, 2010).…”

Patterns of Symptoms of Perinatal Depression and Stress in Late Adolescent and Young Adult Mothers

“…Well-established risk factors for PPD include a previous history of depression (Silverman et al, 2017), antenatal depression (Kettunen & Hintikka, 2017), low socioeconomic status (Goyal, Gay, & Lee, 2010), poor social support (Kettunen & Hintikka), and history of intimate partner violence (Howard, Oram, Galley, Trevillion, & Feder, 2013). Other risk factors include sleep deprivation (Goyal, Gay, & Lee, 2009) and nutritional deficits (Werner, Miller, Osborne, Kuzava, & Monk, 2015).…”

A Practice‐Based Research Database to Study Perinatal Nurse Home Visiting to Pregnant Women With Diabetes

“…Therefore, meaningful analyses may be difficult to conduct, at this stage, involving all the variables. Given recent scientific interest in the relationship between gestational diabetes and depression (Silverman et al., ), it would be of great advantage to pursue higher completion rates on these variables. Table reflects patterns of missing data.…”

“…Hyperglycemia in the later part of pregnancy is associated with high birth weight, increased risk of admission to the neonatal intensive care unit (NICU) related to neonatal hypoglycemia, childhood and adult obesity, and type 2 diabetes (Durnwald & Landon, ; Nehring, Chmitorz, Reulen, Von Kries, & Ensenauer, ). In recent reports, gestational diabetes is implicated as an independent risk factor for postpartum depression (Silverman et al., ), which, in turn, affects socio‐emotional development and later mental health of the offspring (Verbeek et al., ).…”