Summary: Researchers are calling for postnatal depression risk screening for women with persistent depression while they are still pregnant.
Source: University of Queensland
University of Queensland researchers are calling for screening of perinatal depression (PND) for all women during pregnancy, after finding women with persistent depression are at high risk of developing the condition.
Ph.D. candidate Dr. Jacqueline Kiewa from UQ’s Child Health Research Centre compared the perinatal experiences of women with lifetime major depression and found almost three quarters of them had at least one episode of PND.
“Of the 7,182 participants in the study, 5,058 (70 percent) experienced perinatal depression,” Dr. Kiewa said.
Those who experienced perinatal depression—during pregnancy or within six months after giving birth—were more likely to experience severe, complex and frequent depressive episodes and earlier onset of symptoms.
“These women were more likely to have other psychiatric illness such as Attention Deficit Hyperactivity Disorder, and respond less to anti-depressants,” Dr. Kiewa said.
The research found they were also more likely to experience severe nausea and vomiting during pregnancy.
Dr. Kiewa described the findings as concerning.
“In Australia, PND is a leading cause of disease in women who give birth and puts children at risk of developing cognitive and emotional problems,” she said.
Dr. Kiewa said Australian women of non-European and Indigenous ancestry and those who have a history of trauma had a higher risk of PND.
“Some of the characteristics we identified suggest environmental influences as the cause of PND in women with depression, while others point to genetic and biological reasons that may be specific to women and pregnancy,” she said
“Very few PND studies have considered whether mothers have ADHD or other psychiatric illnesses.”
“This is why it’s important that perinatal depression screening be included in all perinatal examinations.”
The research is published in the journal BMJ Open.
Lifetime prevalence and correlates of perinatal depression in a case-cohort study of depression
This study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression.
The Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms.
In a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively).
Primary and secondary outcome measures
The primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures.
The prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, p<0.001), non-European ancestry (OR 1.5, 95% CI 1.0 to 2.1, p=0.03), severe nausea during pregnancy (OR 1.3, 95% CI 1.1 to 1.6, p=0.006) and emotional abuse (OR 1.4, 95% CI 1.1 to 1.7, p=0.005).
The majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.