Risk factors - postpartum depression

Q: 32 years old female, four weeks postpartum, is admitted to ICU with severe depression and suicidal ideation. Which of the following is more of a risk factor for postpartum depression? (select one)

A) Primiparity

B) Multiparity

Answer: B

Risk factors for postpartum major depression is divided into primary and secondary;

Primary:

• Depression during pregnancy
• A prior history of depression, either perinatal or non-perinatal

Secondary: 

• Stressful life events
• Poor social and financial support in the puerperium
• Perinatal anxiety symptoms and disorders
• Young age 
• Single marital status
• Multiparity
• Family history of postpartum depression or psychiatric illness
• Intimate partner violence 
• lifetime history of physical and/or sexual abuse
• Unintended/unwanted pregnancy [14,15,41,58]
• Negative attitudes toward pregnancy
• Fear of childbirth
• Poor perinatal physical health 
• Body image dissatisfaction
• Personality traits, such as neuroticism 
• History of premenstrual syndrome 
• Perinatal sleep disturbance 
• Season of delivery (mostly winter - less daylight)
• Adverse pregnancy and neonatal outcomes
• Breastfeeding issues 
• Childcare stress such as difficult infant temperament

#ob-gyn

#psychiatry

References:

1. O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol 2013; 9:379.

2. Agrawal I, Mehendale AM, Malhotra R. Risk Factors of Postpartum Depression. Cureus. 2022 Oct 31;14(10):e30898. doi: 10.7759/cureus.30898. PMID: 36465774; PMCID: PMC9711915.

3. Dubey A, Chatterjee K, Chauhan VS, Sharma R, Dangi A, Adhvaryu A. Risk factors of postpartum depression. Ind Psychiatry J. 2021 Oct;30(Suppl 1):S127-S131. doi: 10.4103/0972-6748.328803. Epub 2021 Oct 22. PMID: 34908678; PMCID: PMC8611548.