Get Help for Depression in Pregnancy

Postpartum depression in women may begin during pregnancy

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Depression can take all the fun out of being a new mother. Researchers are trying to find better ways to diagnose the problem early.

New research found that how and when women become depressed around the time they become pregnant may be an indicator of how serious the problem is. A report from the University of North Carolina (UNC) School of Medicine found that women whose depression started during pregnancy faced the highest risk of severe depression.

The authors of this study said they plan further research to identify better ways to spot symptoms of depression related to pregnancy in women. This research could improve diagnosis and care.

“We now understand that postpartum depression can have onset of symptoms that may begin in pregnancy," said lead study author Samantha Meltzer-Brody, MD, director of the Perinatal Psychiatry Program at the UNC Center for Women's Mood Disorders in Chapel Hill, in a press release.

Dr. Meltzer-Brody added, "We are now working to apply our findings from this work to future biological and genetic studies of depression in women across the [time before and after giving birth].”

Dr. Meltzer-Brody told dailyRx News that some women who develop complications during pregnancy should see a mental health professional.

"At the very least, these women must be closely followed by the obstetrical provider as they are at higher risk," she said. "Screening for psychiatric symptoms of postpartum depression and anxiety should be done. Some women will require a mental health referral."

Postpartum depression — which means depression after pregnancy — affects 10 to 15 percent of women, Dr. Meltzer-Brody and colleagues said.

Dr. Meltzer-Brody and team used data from a large study called Postpartum Depression: Action Towards Causes and Treatment (PACT), which included more than 25 researchers in seven countries. They assessed records from almost 18,000 women and divided them into three groups based on symptoms of depression and other factors.

Although postpartum depression is a well-known complication of pregnancy, the exact cause is unknown. Various professional organizations define the condition differently. Some experts see it as a distinct condition that is unrelated to pregnancy.

The dramatic changes in women’s hormones that occur during pregnancy and birth may have an effect, Dr. Meltzer-Brody and team noted. Some women may be more sensitive to such changes.

Risk factors for postpartum depression include a personal or family history of mood disorders like depression. Other risk factors are bipolar disorder (sometimes called manic depression), past miscarriage or stillbirth, life stress and a lack of social support. Women who have had postpartum depression in the past are at higher risk than those who have never had postpartum depression.

Women who are depressed may have difficulty caring for their infants. Severe depression is a serious issue that warrants immediate treatment.

Psychiatrists are looking for better ways to identify symptoms and screen and treat patients.

Dr. Meltzer-Brody and colleagues used a tool called the Edinburgh Postnatal Depression Scale (EPDS) to measure symptoms of depression.

These researchers found that women who became depressed during pregnancy were more likely to have severe depression. Dr. Meltzer-Brody and team noted that these women were also more likely to have had complications during the birth itself.

Women who became depressed after the baby was born typically had less severe depression. Complications in these women were more likely to occur during the pregnancy than during the birth.

This study was published online Jan. 15 in The Lancet Psychiatry.

PACT is funded by government, professional and private sources throughout the world, as well as medication manufactures like Pfizer. The authors disclosed no conflicts of interest.

Review Date: 
January 18, 2015
Last Updated:
January 20, 2015