Perinatal depression linked to increased risk of death

Women who suffer depression during or after pregnancy have a higher risk of death by both natural and unnatural causes, a new study of childbirth in Sweden published in The BMJ reports. The increased risk peaks in the month after diagnosis but remains elevated for as long as 18 years afterwards.

Women who develop perinatal depression, which is to say depression during pregnancy or shortly after childbirth, are generally twice as likely to die of natural or, as in most cases, unnatural causes.

These are the results of a large cohort study that used data from the Swedish Medical Birth Register, which effectively contains all births in Sweden since 1973.

Basing their study on women who had live births between 2001 and 2018, the researchers compared over 86,500 women diagnosed with perinatal depression, during pregnancy or up to one year after childbirth, with over 865,500 matched controls of the same age who had given birth the same year.

“This is a cohort study, and although it can’t prove any causality, it’s the largest and most comprehensive study in its field,” says Qing Shen, affiliated researcher at the Institute of Environmental Medicine, Karolinska Institutet and one of the principal authors of the study. “I believe that our study clearly shows that these women have an elevated mortality risk and that this is an extremely important issue.”

The risk was highest for the women diagnosed with postpartum depression (depression after childbirth), corroborating the findings of previous smaller studies. Women diagnosed with antepartum depression (depression during pregnancy) have not been studied as much, so the knowledge base there is smaller. Dr Shen and her colleagues can now show that women with antepartum depression also have an elevated mortality risk, albeit not as high.

Reference: Perinatal depression linked to increased risk of death; BMJ, DOI:10.1136/bmj-2023-075462