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. 2017 Feb;34(2):178-187.
doi: 10.1002/da.22597. Epub 2017 Jan 18.

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

Michael E Silverman  1 , Abraham Reichenberg  1   2 , David A Savitz  3   4 , Sven Cnattingius  5 , Paul Lichtenstein  6 , Christina M Hultman  6 , Henrik Larsson  6   7 , Sven Sandin  1   6
Affiliations

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

Michael E Silverman et al. Depress Anxiety. 2017 Feb.

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 this study was to examine the impact of a depression history on PPD and pre- and perinatal risk factors.

Methods: A nationwide prospective cohort study of all women with live singleton births in Sweden from 1997 through 2008 was conducted. Relative risk (RR) of clinical depression within the first year postpartum and two-sided 95% confidence intervals were estimated.

Results: The RR 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 gestational diabetes (1.70 (1.36-2.13)). Among women with a history of depression, pregestational 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)), 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 (RR = 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.

Keywords: assessment/diagnosis; depression; epidemiology; maternal-child; pregnancy and postpartum.

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Conflict of interest statement

DISCLOSURE OF POTENTIAL CONFLICTS OF INTERESTS

H Larsson has served as a speaker for Eli-Lilly and Shire and has received a research grant from Shire; all outside the submitted work.

Conflict of Interest Disclosures: Larsson has served as a speaker for Eli-Lilly and has received a research grant from Shire; both outside the submitted work.

Figures

Figure 1
Figure 1
Rates (cases/10,000 births) of PPD during the first 12 month following the date of birth of the child comparing women with (red) and without (blue) a history of depression.
Figure 2
Figure 2
Survival curves for PPD during the first 30 days following the date of birth of the child comparing women with (red) and without (blue) a history of depression.
See this image and copyright information in PMC

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