Obstetrical events and bad memories of childbirth tied to higher risks of post-partum depression, Study finds

Postpartum depression is a leading cause of maternal morbidity and mortality and is associated with deleterious long-term developmental and behavioral effects in infants. Recent research study aimed to assess the prevalence and risk factors of postpartum depression among women with vaginal births without major pregnancy complications. The study collected data from 2811 women and found a prevalence of postpartum depression of 9.9% with a score of 13 on the Edinburgh Postnatal Depression Scale (EPDS) and 15.5% with a cutoff value of 11. The study identified several risk factors associated with postpartum depression, including age, migration from North Africa, previous abortion, psychiatric history, induced labor, operative vaginal delivery, and bad memories of childbirth. The authors suggest that a screening approach targeting these risk factors may help identify women at risk of postpartum depression who could benefit from early intervention. The study aimed to assess the prevalence and risk factors of postpartum depression among women with vaginal births without major pregnancy complications. It was an ancillary cohort study of the TRanexamic Acid for Preventing Postpartum Hemorrhage After Vaginal Delivery randomized controlled trial, which was conducted in 15 French hospitals from 2015 to 2016. The characteristics of labor, delivery, and the immediate postpartum experiences were prospectively collected, and the prevalence of postpartum depression was assessed 2 months after childbirth using the EPDS. The study found a prevalence of postpartum depression of 9.9% with a score of 13 on the EPDS and 15.5% with a cutoff value of 11. The study identified several risk factors associated with postpartum depression, including age, migration from North Africa, previous abortion, psychiatric history, induced labor, operative vaginal delivery, and bad memories of childbirth. Prepregnancy vulnerability factors, such as age, previous abortion, and psychiatric history, were found to be associated with a higher risk of postpartum depression. Additionally, characteristics of labor and delivery, such as induced labor and operative vaginal delivery, were also found to be associated with postpartum depression. The study also found that bad memories of childbirth in the immediate postpartum were strongly associated with postpartum depression symptoms at 2 months after giving birth.

Conclusions of the Study

In conclusion, the study found that approximately 10% of women with vaginal deliveries have postpartum depression symptoms 2 months after childbirth. The study identified several risk factors associated with postpartum depression, including age, migration from North Africa, previous abortion, psychiatric history, induced labor, operative vaginal delivery, and bad memories of childbirth. The authors recommend a screening approach targeting these risk factors to help identify women at risk of postpartum depression who could benefit from early intervention. The study provides valuable insights into the prevalence and risk factors of postpartum depression among women with vaginal deliveries without major pregnancy complications.

Methodology and Data Analysis

The study's detailed methodology included the use of the Edinburgh Postnatal Depression Scale (EPDS) as a validated self-administered questionnaire to assess postpartum depression. Data were collected from a relatively large sample of 2811 women, and the study used multivariate logistic regression to analyze associations between potential risk factors and postpartum depression. Additionally, the study considered attrition bias related to nonrespondents in the data analysis and calculated the corrected prevalence of postpartum depression to account for potential selection bias. The study also conducted sensitivity analyses using different cutoff values for the EPDS score to assess the prevalence of postpartum depression. Overall, the study provides a comprehensive assessment of the prevalence and risk factors of postpartum depression among women with vaginal births without major pregnancy complications. The findings contribute to the understanding of postpartum depression and highlight the potential importance of early intervention for women at risk. The study's rigorous methodology and detailed analysis make it a valuable contribution to the research on postpartum depression and maternal mental health following childbirth.

Key Points

- The study aimed to assess the prevalence and risk factors of postpartum depression among women with vaginal births without major pregnancy complications. Data from 2811 women revealed a prevalence of 9.9% with an Edinburgh Postnatal Depression Scale (EPDS) score of 13 and 15.5% with a cutoff value of 11.

- Risk factors associated with postpartum depression were identified, including age, migration from North Africa, previous abortion, psychiatric history, induced labor, operative vaginal delivery, and bad memories of childbirth. Prepregnancy vulnerability factors, such as age, previous abortion, and psychiatric history, were associated with a higher risk of postpartum depression.

- The study found that characteristics of labor and delivery, such as induced labor and operative vaginal delivery, were also associated with postpartum depression. Additionally, bad memories of childbirth in the immediate postpartum were strongly associated with postpartum depression symptoms at 2 months after giving birth.

- The study concluded that approximately 10% of women with vaginal deliveries have postpartum depression symptoms 2 months after childbirth. It recommended a screening approach targeting identified risk factors for early intervention. - The study utilized the EPDS as a validated self-administered questionnaire and conducted data analysis using multivariate logistic regression. It also accounted for potential selection bias and conducted sensitivity analyses using different cutoff values for the EPDS score.

- Overall, the study’s rigorous methodology and detailed analysis contribute valuable insights into the prevalence and risk factors of postpartum depression among women with vaginal deliveries without major pregnancy complications, emphasizing the potential importance of early intervention for at-risk women.

Reference -

Froeliger A, Deneux-Tharaux C, Loussert L, Bouchghoul H, Madar H, Sentilhes L; TRanexamic Acid for Preventing Postpartum Hemorrhage After Vaginal Delivery Study Group. Prevalence and risk factors for postpartum depression 2 months after a vaginal delivery: a prospective multicenter study. Am J Obstet Gynecol. 2024 Mar;230(3S):S1128-S1137.e6. doi: 10.1016/j.ajog.2023.08.026. Epub 2023 Nov 14. PMID: 38193879.