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ORIGINAL RESEARCH |
From the Department of Health and Environment, Division of Obstetrics and Gynaecology, and Department of Neuroscience and Locomotion, Division of Psychiatry, Faculty of Health Sciences, University of Linköping, Linköping, Sweden; Department of Obstetrics and Gynaecology, Värnamo, Sweden; Department of Obstetrics and Gynaecology, Norrköping, Sweden; and Department of Obstetrics and Gynaecology, Kalmar, Sweden.
Address reprint requests to: Ann Josefsson, MD, Division of Obstetrics and Gynaecology, University of Linköping, University Hospital, Linköping, SE-581-85, Sweden; E-mail: ann.josefsson{at}lio.se.
OBJECTIVE: To identify and test the predictive power of potential independent risk factors of postpartum depressive symptoms during pregnancy and the perinatal period.
METHODS: We conducted a case-control study where 132 women with postpartum depressive symptoms were selected as an index group and 264 women without depressive symptoms as a control group. Data related to sociodemographic status, medical, gynecologic, and obstetric history, pregnancy, and perinatal events were collected from standardized medical records.
RESULTS: The strongest risk factors for postpartum depressive symptoms were sick leave during pregnancy and a high number of visits to the antenatal care clinic. Complications during pregnancy, such as hyperemesis, premature contractions, and psychiatric disorder were more common in the postpartum depressed group of women. No association was found between parity, sociodemographic data, or mode of delivery and postpartum depressive symptoms.
CONCLUSION: Women at risk for postpartum depression can be identified during pregnancy. The strongest risk factors, sick leave during pregnancy and many visits to the antenatal care clinic, are not etiologic and might be of either behavioral or biologic origin. The possibilities of genetic vulnerability and hormonal changes warrant further investigation to reach a more thorough understanding.
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