Within the common inhabitants, about 15% of girls will expertise despair after the delivery of a kid. Given the downstream results of postpartum despair (PPD) on the kid’s well being and well-being, it’s important that we be capable to determine girls at excessive danger for experiencing PPD. The identification of danger components earlier than supply — and even earlier than being pregnant — would permit us to observe excessive danger girls extra carefully and may afford the chance to provoke preventative interventions which mitigate danger for sickness.
A scientific evaluation and meta-analysis from Zacher Kjeldsen and colleagues examined the affiliation between household historical past of psychiatric sickness and danger for postpartum despair. Of their remaining evaluation, a complete of 26 research have been included, containing info on 100,877 girls. The meta-analysis confirmed a twofold elevated odds ratio (OR) of creating PPD when moms had a household historical past of psychiatric sickness (OR, 2.08; 95% CI, 1.67-2.59).
The meta-analysis from the present examine signifies an virtually twofold enhance in danger of PPD in moms with a household historical past of psychiatric problems in contrast with moms with out household historical past. In different phrases, girls with a household historical past of psychiatric sickness could have a 30% danger of experiencing PPD. Whereas it is a helpful piece of knowledge, that is most probably not a shock to most. We all know that having a household historical past of psychiatric sickness will increase one’s danger for despair, and having a historical past of despair will increase danger for PPD. (Nevertheless, some research haven’t proven an affiliation between household historical past of psychiatric sickness and PPD.)
The present examine didn’t take a look at particular psychiatric problems. In one other examine analyzing information from the Danish medical register, researchers noticed that if a lady had a first-degree relative (mom, father, brother, sister, or little one) with a historical past of any psychiatric dysfunction, her danger of getting an episode of postpartum psychiatric sickness was about 1.5-fold larger than in girls with no household historical past. Nevertheless, if the girl had a first-degree relative with a historical past of bipolar dysfunction, her danger of getting an episode of postpartum psychiatric sickness elevated practically threefold. (In distinction to the examine from Zacher Kjeldsen and colleagues, the Danish examine checked out danger solely in girls with no private historical past of psychiatric sickness previous to being pregnant.)
Each research remind us to ask about household historical past on either side of the household. Whereas having a mom or sister who has skilled postpartum psychiatric sickness might enhance a lady’s danger of PPD, having a brother or father with any sort of psychiatric sickness additionally confers important danger.
What we don’t but know is how varied danger components — comparable to depressive signs throughout being pregnant or discontinuation of medicines — work together with one another, nor do we all know how protecting components (e.g., social helps) might modulate danger. Our final objective can be to generate some form of PPD danger calculator in order that we may consider every lady and provides a extra customized estimate of danger for perinatal psychiatric sickness and to pick out applicable preventative interventions. That is possibly the place massive information can assist us.
Ruta Nonacs, MD PhD
Zacher Kjeldsen MM, Bricca A, Liu X, Frokjaer VG, Madsen KB, Munk-Olsen T. Household Historical past of Psychiatric Problems as a Threat Issue for Maternal Postpartum Melancholy: A Systematic Evaluate and Meta-analysis. JAMA Psychiatry. 2022 Aug 17.