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One episode of postpartum depression raises likelihood of more

From Reuters - September 29, 2017

(Reuters Health) - Depression after giving birth is rare among women with no history of psychiatric disorders, but once postpartum depression occurs, the odds are much higher that it will happen again after subsequent births, researchers say.

Among more than 450,000 first-time mothers in Denmark with no prior bouts of depression, less than 1 percent had postpartum depression after giving birth. But those who did were 27 to 46 times more likely to experience it again after later births, researchers found.

Overall, about 5 percent to 15 percent of all mothers are diagnosed with depression after giving birth, the study team notes in PLoS Medicine. A history of psychiatric disorders before giving birth increases the risk of postpartum depression significantly.

The risk of postpartum affective disorder (AD) among women with no previous psychiatric disease is low, lead study author Marie-Louise Rasmussen told Reuters Health in an email.

But for women who do develop postpartum depression, the risk of a later affective disorder is increased and the risk of a recurrent postpartum affective disorder episode is relatively high, said Rasmussen, a researcher with Statens Serum Institut in Copenhagen.

The researchers analyzed data on 457,317 Danish women who had their first babies between 1996 and 2013 and had no history of hospital visits for psychiatric problems or use of antidepressants. During the study, the women had a total of 789,068 births.

Just 0.6 percent of the births were associated with treatment for postpartum depression. The treatment was relatively short in most cases.

Compared to women who didnt have postpartum depression after their first childbirth, those who did and were treated with antidepressants were 27 times more likely to have postpartum depression after giving birth again. Women hospitalized for a first episode of postpartum depression were 46 times more likely to experience postpartum depression after a subsequent birth.

The findings underline the seriousness of first-time postpartum depression and the need for both primary and secondary preventive measures, Rasmussen said.

As for all women contemplating to have more children, social support from the spouse and surroundings is very important - probably even more so for women with a previous history of postpartum AD, she said.

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