The incidence of depressive episodes is different before, during, and after pregnancy: A population-based study

Molenaar, Nina M.; Mægbæk, Merete Lund; Rommel, Anna‐Sophie; Ibroci, Erona; Liu, Xiaoqin; Munk‐Olsen, Trine

doi:10.1016/j.jad.2022.11.031

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…We found no clear evidence of genetic heterogeneity between PPD and MDD. These results jointly feed into an ongoing discussion if PPD is a distinct disorder from MDD [ 5 , 39 ], and also directly into consideration if treatment for PPD and MDD should be similar, especially when new pharmacological strategies explicitly for PPD are emerging [ 5 , 40 ].…”

Section: Discussionmentioning

confidence: 97%

Postpartum and non-postpartum depression: a population-based matched case-control study comparing polygenic risk scores for severe mental disorders

Munk-Olsen,

Di Florio,

Madsen

et al. 2023

Transl Psychiatry

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It remains inconclusive whether postpartum depression (PPD) and depression with onset outside the postpartum period (MDD) are genetically distinct disorders. We aimed to investigate whether polygenic risk scores (PGSs) for major mental disorders differ between PPD cases and MDD cases in a nested case-control study of 50,057 women born from 1981 to 1997 in the iPSYCH2015 sample in Demark. We identified 333 women with first-onset postpartum depression (PPD group), who were matched with 993 women with first-onset depression diagnosed outside of postpartum (MDD group), and 999 female population controls. Data on genetics and depressive disorders were retrieved from neonatal biobanks and the Psychiatric Central Research Register. PGSs were calculated from both individual-level genetic data and meta-analysis summary statistics from the Psychiatric Genomics Consortium. Conditional logistic regression was used to calculate the odds ratio (OR), accounting for the selection-related reproductive behavior. After adjustment for covariates, higher PGSs for severe mental disorders were associated with increased ORs of both PPD and MDD. Compared with MDD cases, MDD PGS and attention-deficit/hyperactivity disorder PGS were marginally but not statistically higher for PPD cases, with the OR of PPD versus MDD being 1.12 (95% CI: 0 .97–1.29) and 1.11 (0.97–1.27) per-standard deviation increase, respectively. The ORs of PPD versus MDD did not statistically differ by PGSs of bipolar disorder, schizophrenia, or autism spectrum disorder. Our findings suggest that relying on PGS data, there was no clear evidence of distinct genetic make-up of women with depression occurring during or outside postpartum, after taking the selection-related reproductive behavior into account.

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Section: Discussionmentioning

confidence: 97%

Postpartum and non-postpartum depression: a population-based matched case-control study comparing polygenic risk scores for severe mental disorders

Munk-Olsen,

Di Florio,

Madsen

et al. 2023

Transl Psychiatry

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“…Furthermore, it has been argued that postpartum depression could be considered a distinct disorder from pregnancy-onset depression due to differences in hormonal fluctuation and greater symptom severity [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, it has also been suggested to replace the DSM specification “with perinatal onset” with the distinction of times of onset: depression with pregnancy onset OR with postpartum onset [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Psychological Characteristics of Women with Perinatal Depression Who Require Psychiatric Support during Pregnancy or Postpartum: A Cross-Sectional Study

Terrone

Bianciardi

Fontana

et al. 2023

IJERPH

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Antenatal depression may be distinct from postpartum depression in terms of prevalence, severity of symptoms, comorbidities, prognosis, and risk factors. Although risk factors for perinatal depression have been identified, it is unclear whether there are differences in the onset of perinatal depression (PND). This study explored the characteristics of women requiring mental health support during pregnancy or postpartum. A sample of 170 women (58% in pregnancy; 42% postpartum) who contacted the SOS-MAMMA outpatient clinic was recruited. Clinical data sheets and self-report questionnaires (EPDS, LTE-Q, BIG FIVE; ECR; BSQ; STICSA) were administered, hypothesizing possible risk factors, such as personality traits, stressful life events, body dissatisfaction, attachment style, and anxiety. Hierarchical regression models were carried out in the pregnancy (F10;36 = 8.075, p < 0.001, adjR2 = 0.877) and postpartum groups (F10;38 = 3.082, p < 0.05, adjR2 = 0.809). Recent stressful life events and conscientiousness were associated with depression in both the pregnant (29.3%, 25.5% of variance) and postpartum groups (23.8%, 20.7% of variance). In pregnant women, “openness” (11.6%), body dissatisfaction (10.2%), and anxiety (7.1%) symptoms were predictive of depression. In the postpartum group, “neuroticism” (13.8%) and insecure romantic attachment dimensions (13.4%; 9.2%) were the strongest predictors. Perinatal psychological interventions should consider the differences between mothers with depression during pregnancy and postpartum.

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“…demonstrates that inpatient admissions for depression are highest in the 12 months after childbirth, compared with admissions in the time immediately prior to and during pregnancy. 1,2 PPD has prevalence estimates of 12%-20% worldwide and is associated with significant morbidity for mothers and their infants. [3][4][5][6][7] Risk factors for the development of PPD include prior diagnosis with a psychiatric condition, low socioeconomic status, substance abuse, lack of partner support, and past or current abuse.…”

mentioning

confidence: 99%

“…Postpartum depression (PPD) is defined by the American College of Obstetricians and Gynecologists as a major depressive episode beginning in the first year after childbirth; new research demonstrates that inpatient admissions for depression are highest in the 12 months after childbirth, compared with admissions in the time immediately prior to and during pregnancy 1,2 . PPD has prevalence estimates of 12%–20% worldwide and is associated with significant morbidity for mothers and their infants 3–7 .…”

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confidence: 99%

Brexanolone Treatment in a Real-World Patient Population

Guard,

Labonte,

Mendoza

et al. 2024

J Clin Psychopharmacol

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Purpose/Background Brexanolone is approved for postpartum depression (PPD) by the United States Food and Drug Administration. Brexanolone has outperformed placebo in clinical trials, but less is known about the efficacy in real-world patients with complex social and medical histories. Furthermore, the impact of brexanolone on large-scale brain systems such as changes in functional connectivity (FC) is unknown. Methods/Procedures We tracked changes in depressive symptoms across a diverse group of patients who received brexanolone at a large medical center. Edinburgh Postnatal Depression Scale (EPDS) scores were collected through chart review for 17 patients immediately prior to infusion through approximately 1 year postinfusion. In 2 participants, we performed precision functional neuroimaging (pfMRI), including before and after treatment in 1 patient. pfMRI collects many hours of data in individuals for precision medicine applications and was performed to assess the feasibility of investigating changes in FC with brexanolone. Findings/Results The mean EPDS score immediately postinfusion was significantly lower than the mean preinfusion score (mean change [95% CI]: 10.76 [7.11–14.40], t(15) = 6.29, P < 0.0001). The mean EPDS score stayed significantly lower at 1 week (mean difference [95% CI]: 9.50 [5.23–13.76], t(11) = 4.90, P = 0.0005) and 3 months (mean difference [95% CI]: 9.99 [4.71–15.27], t(6) = 4.63, P = 0.0036) postinfusion. Widespread changes in FC followed infusion, which correlated with EPDS scores. Implications/Conclusions Brexanolone is a successful treatment for PPD in the clinical setting. In conjunction with routine clinical care, brexanolone was linked to a reduction in symptoms lasting at least 3 months. pfMRI is feasible in postpartum patients receiving brexanolone and has the potential to elucidate individual-specific mechanisms of action.

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The incidence of depressive episodes is different before, during, and after pregnancy: A population-based study

Cited by 8 publications

References 30 publications

Postpartum and non-postpartum depression: a population-based matched case-control study comparing polygenic risk scores for severe mental disorders

Postpartum and non-postpartum depression: a population-based matched case-control study comparing polygenic risk scores for severe mental disorders

Psychological Characteristics of Women with Perinatal Depression Who Require Psychiatric Support during Pregnancy or Postpartum: A Cross-Sectional Study

Brexanolone Treatment in a Real-World Patient Population

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