Predictors and incidence of post‐partum depression: A longitudinal cohort study

Abdollahi, Fatemeh; Zarghami, Mehran; Azhar, Zain; Sazlina, Shariff-Ghazali; Lye, Munn-Sann

doi:10.1111/jog.12471

Cited by 51 publications

(53 citation statements)

References 54 publications

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“…We found that GDM substantially increased a woman’s risk of postpartum depression approximately fourfold. Our findings in a low-risk, diverse, US sample confirm those of a prior study from Iran [15]. Interestingly, other studies of the association between GDM and postpartum depression have been null, but these studies either assessed depression much later, at 6 months postpartum [12], or used a self-report of depression [13], unlike our study, which used a validated measure of depressive symptoms at 6 weeks postpartum.…”

Section: Discussionsupporting

confidence: 81%

A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period

et al. 2016

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Aims/hypothesis Depression and glucose intolerance commonly co-occur among non-pregnant individuals; however, the temporal relationship between gestational diabetes (GDM) and depression during pregnancy and the postpartum period is less understood. Our objective was to assess longitudinal associations between depression early in pregnancy and GDM risk, as well as GDM and subsequent risk of postpartum depression. Methods Data came from the prospective National Institute of Child Health and Human Development Fetal Growth Studies-Singleton cohort (2009–2013), and had been collected at 12 US clinical centres. Pregnant women without psychiatric disorders, diabetes or other chronic conditions before pregnancy were followed throughout pregnancy (n=2477). Only women with GDM and matched controls were followed up at 6 weeks postpartum (n=162). GDM was ascertained by a review of the medical records. Depression was assessed in the first (8–13 gestational weeks) and second (16–22 weeks) trimesters and at 6 weeks postpartum using the Edinburgh Postnatal Depression Scale. Postpartum depression was defined as a depressive symptom score ≥10 or antidepressant medicine use after delivery. RR and 95% CI we adjusted for pre-pregnancy BMI and other risk factors. GDM was considered to be the outcome for the first set of analyses, with depression in the first and second trimesters as the exposures. Postpartum depression was considered as the outcome for the second set of analyses, with GDM as the exposure. Results Overall, comparing the highest and lowest quartiles of first-trimester depression scores, the scores from the highest quartile were associated with a significant twofold (95% CI 1.06, 3.78) increased risk of GDM, but this was attenuated to 1.72-fold (95% CI 0.92, 3.23) after adjustment; the second-trimester results were similar. The risk was stronger and significant in both trimesters among non-obese women (p for trend 0.02 and 0.01, respectively), but null for obese women. Women with persistently high depression scores in both trimesters had the greatest risk of GDM (highest vs lowest quartile in both trimesters: adjusted RR 3.21, 95% CI 1.00–10.28). GDM was associated with an adjusted 4.62-fold (95% CI 1.26, 16.98) increased risk of subsequent postpartum depression. Conclusions/interpretation This prospective study demonstrates a modest association between depressive symptoms early in pregnancy and an increased risk of incident GDM, as well as between GDM and subsequent postpartum depression risk, highlighting pregnancy and the postpartum period as an important susceptible time window during the life course for the interplay between depression and glucose intolerance phenotypes. GDM risk associated with elevated depressive symptoms was particularly high among non-obese women and women with symptoms persisting across the first two trimesters of pregnancy.

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Section: Discussionsupporting

confidence: 81%

A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period

et al. 2016

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“…Of these, 46 publications were selected for inclusion[20-65]. Manual screening of bibliographies identified two additional relevant studies[66,67].…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 48 publications were included in this review (Figure 1, Table 1, Table 2, Table 3, Supplementary Table 1). Of these, 30 described prospective observational studies[20,21,23,24,26,27,29-31,34,35,37,38,41,43-45,47-49,51,54,57,58,60-62,65-67], 15 described retrospective observational studies[22,25,28,32,39,40,42,46,50,53,55,56,59,63,64], and three described randomized controlled trials (RCTs)[33,36,52], two of which reported only baseline data[36,52]. Two publications described the same study, but reported different subgroup analyses[23,29].…”

Section: Resultsmentioning

confidence: 99%

“…A total of 28 studies included only women with GDM[20,23,26-29,31,33,35-38,40,43-45,47-49,51-53,57,58,60,61,63,64], 14 included women with either GDM or pre-existing diabetes (although the type was not always reported)[22,25,39,41,42,46,50,54-56,59,62,65,66], one included women with either GDM or type 1 diabetes[34], one included only women with type 1 diabetes[67], one included only women with pre-existing diabetes (type not reported)[30] and three did not report the type of diabetes[21,24,32] (Tables 1-3, Supplementary Table 1). Sample sizes ranged from 36[65] to more than 32 million in a retrospective analysis of a nationwide hospital database[22] (Tables 1-3, Supplementary Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…There were 22 studies that measured depression only during pregnancy[22,24,26,30,31,36,37,40,41,43,45,51,53-55,57-59,61,64,66,67]. Conversely, 11 studies focussed on postpartum depression, most commonly measured within the first 3 mo[20,21,23,25,27,29,33,47,52,62,63]. There were nine studies that measured depression during both pregnancy and postpartum[34,35,38,39,42,44,46,49,65] and five studies that classified participants based on a history of pre-pregnancy depression[28,32,50,56,60].…”

Section: Resultsmentioning

confidence: 99%

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Relationship between depression and diabetes in pregnancy: A systematic review

Ross

Falhammar

Chen

et al. 2016

WJD

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AIMTo systematically review the literature on women with both diabetes in pregnancy (DIP) and depression during or after pregnancy.METHODSIn this systematic literature review, PubMed/MEDLINE and EMBASE were searched (13 November 2015) using terms for diabetes (type 1, type 2, or gestational), depression, and pregnancy (no language or date restrictions). Publications that reported on women who had both DIP (any type) and depression or depressive symptoms before, during, or within one year after pregnancy were considered for inclusion. All study types were eligible for inclusion; conference abstracts, narrative reviews, nonclinical letters, editorials, and commentaries were excluded, unless they provided treatment guidance.RESULTSOf 1189 articles identified, 48 articles describing women with both DIP and depression were included (sample sizes 36 to > 32 million). Overall study quality was poor; most studies were observational, and only 12 studies (mostly retrospective database studies) required clinical depression diagnosis. The prevalence of concurrent DIP (any type) and depression in general populations of pregnant women ranged from 0% to 1.6% (median 0.61%; 12 studies). The prevalence of depression among women with gestational diabetes ranged from 4.1% to 80% (median 14.7%; 16 studies). Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP. However, there was no clear consensus for either relationship. Importantly, we found limited guidance on the management of women with both DIP and depression.CONCLUSIONGiven the increasing prevalence of diabetes and depression, high-quality research and specific guidance for management of pregnant women with both conditions are warranted.

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Family History of Psychiatric Disorders as a Risk Factor for Maternal Postpartum Depression

et al. 2022

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ImportanceCurrent evidence on the association between family history of psychiatric disorders and postpartum depression is inconsistent; family studies have identified familial risk of postpartum depression, whereas systematic reviews and umbrella reviews, compiling all risk factors for postpartum depression, often have not.ObjectiveTo investigate the association between family history of psychiatric disorders and risk of developing postpartum depression within 12 months post partum.Data SourcesLiterature searches were conducted in PubMed, Embase, and PsycINFO in September 2021 and updated in March 2022, accompanied by citation and reference search.Study SelectionStudies eligible for inclusion comprised peer-reviewed cohort and case-control studies reporting an odds ratio (OR) or sufficient data to calculate one for the association between family history of any psychiatric disorder and postpartum depression. Study selection was made by 2 independent reviewers: title and abstract screening followed by full-text screening.Data Extraction and SynthesisReporting was performed using the MOOSE checklist. Two reviewers independently extracted predefined information and assessed included studies for risk of bias using the Newcastle-Ottawa Scale. Data were pooled in a meta-analysis using a random-effects model. Heterogeneity was investigated with meta-regression, subgroup, and sensitivity analyses. Publication bias was investigated using a funnel plot, and GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to evaluate the overall certainty of the findings.Main Outcomes and MeasuresThe primary outcome was the pooled association between family history of psychiatric disorders and postpartum depression.ResultsA total of 26 studies were included, containing information on 100 877 women. Meta-analysis showed an increased OR of developing postpartum depression when mothers had a family history of psychiatric disorders (OR, 2.08; 95% CI, 1.67-2.59; I2 = 57.14%) corresponding to a risk ratio of 1.79 (95% CI, 1.52-2.09), assuming a 15% postpartum depression prevalence in the general population. Subgroup, sensitivity, and meta-regression analyses were in line with the primary analysis. The overall certainty of evidence was deemed as moderate according to GRADE.Conclusions and RelevanceIn this study, there was moderate certainty of evidence for an almost 2-fold higher risk of developing postpartum depression among mothers who have a family history of any psychiatric disorder compared with mothers without.

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Predictors and incidence of post‐partum depression: A longitudinal cohort study

Abstract: A high rate of new cases of PPD was identified in Iranian women. A combination of psychological, sociological, obstetric and sociodemographic factors can render mothers vulnerable to post-partum depression.

Cited by 51 publications

References 54 publications

A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period

A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period

Relationship between depression and diabetes in pregnancy: A systematic review

Family History of Psychiatric Disorders as a Risk Factor for Maternal Postpartum Depression

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