Shining a Light on Postpartum Depression

Postpartum depression more likely to affect younger and single women with lower education

March 13, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) The birth of a new baby is often a joyful time in a mother's life. But the experience can also come with anxiety and depression. These conditions should be addressed.

A recent study explored postpartum depression in women and the characteristics of those most likely to have it.

The researchers found that about 14 percent of women in a large study screened positive for postpartum depression. About a fifth of these women had considered harming themselves.  

Women at higher risk for postpartum depression appeared to be those who were single, younger, of a lower education level, using public insurance or African American.

"Seek help if you are feeling depressed."

The study, led by Katherine Wisner, MD, MS, of the Department of Psychiatry at the University of Pittsburgh, aimed to better understand postpartum depression and whether screening would be a good idea.

The researchers gathered data from women who agreed to undergo a telephone screening for postpartum depression four to six weeks after giving birth. Screening was conducted using a standard assessment tool for postpartum depression.

Women who screened positive on the phone were then invited to receive psychiatric assessments in their homes.

Out of 10,000 mothers who were screened, 3.2 percent of the women overall reported thinking about harming themselves, and 14 percent (1,396 women) screened positive for postpartum depression.

Of these, a little over half (59 percent, or 826 women) received a home visit evaluation, and a separate 10.5 percent (147 women) underwent a diagnostic interview (more detailed) on the phone.

Among those who had screened positive, a total of 68.5 percent of the women had depression, and 27 percent had bipolar disorders. Also among these women, 19 percent had thought about harming themselves.

"The most common diagnosis in screen-positive women was major depressive disorder with comorbid generalized anxiety disorder," the authors wrote. "Strategies to differentiate women with bipolar from unipolar disorders are needed.

The researchers found a variety of risk factors the women screening positive for postpartum depression had in common.

African American women, single women and younger women were all more likely to experience postpartum depression. In addition, women experiencing postpartum depression were more likely to be receiving Medicaid or another government insurance and were more likely to have lower levels of education.

Forty percent of the women experienced postpartum depression after they had their babies, but a third of the women (33 percent) experienced depression during their pregnancies. In addition, 26.5 percent of the women experienced depression before their pregnancies.

The researchers concluded well-designed and thoughtful screening programs may benefit new mothers.

"A comprehensive screening and diagnostic characterization coupled with diagnosis-specific intervention strategies might reduce maternal disability, improve function, and avert a new generation at risk," the authors wrote.

The study was published March 13 in the journal JAMA Psychiatry. The research was funded by grant R01 MH 071825 for Identification and Therapy of Postpartum Depression. The lead author has served on the advisory board for Eli Lilly and has received donated medications for a previous unrelated study from Novartis. Another author has consulted for five pharmaceutical companies and served on the board of another.