Perinatal complications increase the risk of postpartum depression. The Generation R Study

Abstract

Objective To examine whether specific pregnancy and delivery complications are risk factors for postpartum depression.Design A prospective longitudinal study.Setting Rotterdam, the Netherlands.Population A cohort of 4941 pregnant women who enrolled in the Generation R Study.Methods Information on perinatal complications was obtained from the midwife and hospital registries or by questionnaire. Logistic regression analyses were used to calculate the risk of postpartum depression for the separate perinatal complications.Main outcome measures Postpartum psychiatric symptoms were assessed 2 months after delivery using the Edinburgh postnatal depression scale.Results Several perinatal complications were significantly associated with postpartum depression, namely: pre-eclampsia (adjusted OR, aOR 2.58, 95% CI 1.30-5.14), hospitalization during pregnancy (aOR 2.25, 95% CI 1.19-4.26), emergency caesarean section (aOR 1.53, 95% CI 1.02-2.31), suspicion of fetal distress (aOR 1.56, 95% CI 1.08-2.27), a medically indicated delivery provided by an obstetrician (aOR 2.43, 95% CI 1.56-3.78), and hospital admission of the baby (aOR 1.45, 95% CI 1.10-1.92). Unplanned pregnancy, thrombosis, meconium-stained amniotic fluid, and Apgar score were not associated with postpartum depression after adjustment for confounding factors, such as pre-existing psychopathological symptoms and sociodemographic characteristics. The risk of postpartum depression increased with the number of perinatal complications women experienced (P < 0.001).Conclusions We showed that several pregnancy and delivery complications present a risk for women's mental health in the postpartum period. Obstetricians, midwives, general practitioners, and staff at baby well clinics should be aware that women who experienced perinatal complications-especially those with a number of perinatal complications-are at risk for developing postpartum depression.

Long-term follow-up of psychosocial distress after early onset preeclampsia: the Preeclampsia Risk EValuation in FEMales cohort study

“…Women with a history of early onset PE report similar levels of psychosocial distress on average 14 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] years after pregnancy as measured by anxiety, (absence of) social support, and personality constructs optimism and Type D personality, when compared to a group without PE. A significantly higher level of depressive symptoms and fatigue was observed, albeit with a very small effect size.…”

“…In a systematic review on this topic, Delahaije and colleagues described six studies on anxiety, depression, and PTSD in women following PE. Two studies were prospective [13,16], and four utilized a historic cohort [15,[17][18][19]. Depressive symptoms, PTSD, or anxiety were assessed a few months up to on average seven years after pregnancy.…”

Personality, depressive symptoms during pregnancy and their influence on postnatal depression in Spanish pregnant Spanish women. [Personalidad, síntomas depresivos en el embarazo y su influencia en la depresión postparto en gestantes españolas]

“…In births that produce neonatal complications (foetal suffering or hospitalization of the new-born) there is an increase of depressive symptoms (Blom et al, 2010). Other variables, such as multiple births don't seem to have such a clear influence, as some researchers have found that there is an increase in the risk of depression (Mayberry et al, 2007) whilst others have found the contrary (Barbadoro et al, 2012).…”

Pogimdyminio Laikotarpio Psichoemocinę Būklę Lemiantys Veiksniai

“…Laiku nepastebėta ir negydyta depresija kenkia motinos ir kūdikio gerovei. Tai gali užkirsti kelią moteriai atliekant kasdieninę veiklą, palaikant ryšį su savo vaiku ar artimais šeimos nariais (5). Deja, didelei daliai moterų depresija nėra teisingai diagnozuojama.…”

“…vidutinis), tuo tarpu tarp moterų, nepatyrusių komplikacijų, depresijos simptomų išreikštumas nustatytas 38,9 proc. moterų (5,6 proc. ryškus ir 33,3 proc.…”