Women who experienced mood disorders during pregnancy may be at risk for more severe postpartum depression (PPD) than those whose symptoms begin after birth, says a recent study.
PPD, which is also known as postnatal depression, is a type of clinical depression which can affect women after childbirth. The researchers found that women with postpartum depression may experience any of three distinct subtypes of clinical presentation, and each of these has important implications for their prognosis and the tailoring of treatments.
The clinical characteristics found to be most relevant in defining the three subtypes were the timing of symptom onset (beginning during pregnancy or after birth), the severity of symptoms (including thoughts of suicide), a history of a previous mood disorder and whether or not a woman had medical complications during pregnancy or childbirth.
“Clinicians should be aware of the diverse presentation of women with postpartum depression,” said Samantha Meltzer-Brody, director of the perinatal psychiatry programme at the University of North Carolina’s centre for women’s mood disorders.
In the study, data from over 10,000 women collected in previous studies were analysed using a statistical technique called latent class analysis widely used in psychiatry.
Women with postpartum depression may experience any of three distinct subtypes of clinical presentation, the researchers found.
“A thorough assessment of a women’s history is necessary to guide appropriate clinical and treatment decisions,” Meltzer-Brody said, “We now understand that postpartum depression can have onset of symptoms that may begin in pregnancy.”
She added, “Improved understanding of the differences in clinical presentation of postpartum depression impacts the implementation and interpretation of screening, diagnosis, treatment, and research of perinatal mood disorders. We are now working to apply our findings from this work to future biological and genetic studies of depression in women across the perinatal period.”
The study was published in the journal The Lancet Psychiatry.