Abstract
We sought to determine clinical predictors of postpartum depression (PPD), including the role of medication, in a sample of women followed prospectively during and after pregnancy. Women with a history of mood disorder were recruited and evaluated during each trimester and 1 week, 1 month, and 3 months postpartum. DSM-IV criteria for a major depressive episode were assessed by a psychiatric interview at each time point. Sixty-three women with major depression and 30 women with bipolar disorder entered the study and 75.4 % met DSM-IV criteria for a MDE during pregnancy, postpartum, or both. We modeled depression in a given time period (second trimester, third trimester, or 1 month postpartum) as a function of medication use during the preceding period (first, second, or third trimester). The odds of being depressed for those who did not use medication in the previous period was approximately 2.8 times that of those who used medication (OR 2.79, 95 % CI 1.38–5.66, p = 0.0048). Of 38 subjects who were psychiatrically well during the third trimester, 39.5 % (N = 15) met the criteria for a MDE by 4 weeks postpartum. In women who developed PPD, there was a high rate of a family history of PPD (53.3 %) compared to women who did not develop PPD (11.8 %, p = 0.02). While the use of psychiatric medications during pregnancy reduced the odds of being depressed overall, the use of psychiatric medications during pregnancy may not protect against PPD in women at high risk, particularly those with a family history of PPD.
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Conflict of interest
Dr. Payne has received research support from Corcept Pharmaceuticals in the past year and legal consulting fees from Pfizer, Johnson and Johnson, and Astra Zeneca. Dr. Meltzer-Brody has received research support from Astra Zeneca. This study was funded by NIH Grant K23 MH074799 at the Johns Hopkins site and by the Foundation of Hope for the University of North Carolina site.
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The study was approved by the Johns Hopkins IRB. All participants gave written informed consent prior to participation in the study.
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Kimmel, M., Hess, E., Roy, P.S. et al. Family history, not lack of medication use, is associated with the development of postpartum depression in a high-risk sample. Arch Womens Ment Health 18, 113–121 (2015). https://doi.org/10.1007/s00737-014-0432-9
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DOI: https://doi.org/10.1007/s00737-014-0432-9