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Postpartum Depression Can Strike With Little Warning

Even new mothers with no history of mental health problems are still at risk, study finds.

One in every 200 women who have no psychiatric history will suffer from postpartum affective disorder or postpartum depression, new research suggests. The findings, published in PLOS Medicine, also indicate that women who experience psychiatric symptoms after their first pregnancies are at higher risk of it coming back with subsequent kids. The study is also among the first to attach hard numbers to the risks and outcomes associated with postpartum depression

“We wanted to provide these women, families, and counselors with estimates on treatment duration and recurrence risk,” study co-author Marie-Louise Rasmussen of the Statens Serum Institut in Denmark told Fatherly. “This has not previously been investigated in this group, and by nationwide data.”

Postpartum depression is one of the most common postnatal complications, affecting anywhere from 5 to 15 percent of women after childbirth. Left untreated, it can lead to decreased emotional regulation and increased health problems, as well as long-term depression. But how often it affects women who have no prior history of psychiatric problems was, until recently, unknown.

So Rasmussen and her team analyzed data on 457,317 Danish women who gave birth to a first child between 1996 and 2013 and had no prior history of psychiatric treatment. They tracked rates of postpartum depression by identifying women who had been prescribed antidepressants or made use of outpatient or hospital-based therapy depression within six months of childbirth. The results suggest that 0.6 percent of women with no histories of psychiatric disease end up with postpartum depression. They also found that 27.9 percent of these women were still in treatment one year later, and that 5.4 percent remained in treatment for at least four years after being diagnosed. By following subsequent pregnancies, they further discovered that women who were on antidepressants during their first pregnancies were 27 times more likely to suffer postpartum depression during their next pregnancy. And those who actually went for therapy were 46 times more likely to have a relapse.

“We were perhaps a bit surprised to find that a large proportion of the women only filled in one prescription of antidepressants,” Rasmussen notes. This probably suggests that most women are prescribed antidepressants to stave off baby blues, and discover that their condition is not severe enough to warrant therapy or regular antidepressant use. But the researchers cannot be sure that that’s the reason. “We cannot conclude anything about the severity of the episodes,” she says. 

stressed mother holding baby

Because the data was obtained from a national registry and not from meeting with patients, it comes with caveats. Rasmussen suspects that milder cases do not appear in the registry, and that some women who were prescribed antidepressants were not in fact suffering from postpartum depression. She recommends follow-up studies that will focus on the biological mechanisms behind maternal depression, in order to identify women who may be high-risk. And then, of course, she recommends working to prevent it. Until then, however, Rasmussen has some advice for expecting moms and dads. “Families should be aware of the traditional warning signs of postpartum depression in women; sleep disturbances, frequent crying, and anxiety,” she says.

And for fathers? “Social support from the spouse and surroundings is always important.”