History of mental illness linked to postpartum depression, PTSD

Women with a history of mental illness may be at a greater risk of developing postpartum mood disorder, a new study has found.

Researchers enrolled 600 women, in whom a history of mental illness was assessed according to self-reports, a medical record review, and past prescriptions of psychiatric medications. The primary outcome was depression, defined as scoring ≥10 on the Edinburgh Postnatal Depression Scale (EPDS). Post-traumatic stress disorder (PTSD), with a score of ≥19 on the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ), was set as a secondary outcome.

Six weeks postpartum, 390 women remained available for follow-up, of whom 16 percent (n=62) screened positive for depression, while 6 percent (n=24) were found to have PTSD. At 3 months postpartum, the respective prevalence rates of the mood disorders were 13 percent and 5 percent.

Time-adjusted generalized estimating equations showed that having a history of a mental illness was a significant risk factor for probable postpartum depression (adjusted odds ratio [OR], 2.12, 95 percent confidence interval [CI], 1.30–3.47; p=0.003) and PTSD (adjusted OR, 3.15, 95 percent CI, 1.42–7.02; p=0.005).

Being nulliparous (p=0.029) and undergoing operative management of postpartum haemorrhage (p=0.030) were also risk factors for developing PTSD within 3 months after birth. No other predictors were found for postpartum depression, though having a low annual household income was of borderline significance (p=0.058).