POSTPARTUM DEPRESSION - RISK-FACTORS

Abstract

An international collaborative study of psychological adjustment in pregnancy and postpartum was carried out in Australia, The Netherlands and Italy. The study aimed to identify factors contributing to a depressed mood postpartum and to determine the way in which these factors interact. The women studied were in their first pregnancy to reach 28 weeks gestation. The study was prospective, with interviews and rating scales repeated at 28 weeks gestation, 4 days postpartum and 4 months postpartum. The major outcome assessment of mood was the Beck Depression Inventory (BDI). Forty-three per cent of women reported experiencing emotional problems in the 4 months after delivery. In 14% of the sample these problems lasted for more than 4 weeks. Using multivariate analysis, the most important factor predicting depressive mood postpartum was the level of depressive symptoms during pregnancy. Other risk factors included the continuation of breastfeeding, age greater than 30 years, and a prior history of mood disorder, particularly that of premenstrual depression. These variables appeared to interact in a multiplicative way. Stress during pregnancy, or delivery and a lack of support from the women's parents, were factors which had an additive effect in predisposing the new mother to depression.