History of Hormonal Contraception Use Linked to Higher Risk of Postpartum Depression: JAMA

Denmark: A new study published in JAMA: Psychiatry suggests that women who have a history of depression associated with hormonal contraception (HC) use may be at a higher risk of developing postpartum depression (PPD).

Hormonal sensitivity in women is linked to depression during specific reproductive phases, but little evidence exists for across-the-lifespan linkages.

The cohort study analyzed the Danish health registry from 1995-2017, studying 269,354 women who gave birth between 1996-2017. Researchers calculated odds ratios for postpartum depression (PPD) based on prior depression associated with or without hormonal contraception (HC) use, defined by a hospital diagnosis or antidepressant prescription.

The study concluded with the following key takeaways:

1. Of 188,648 first-time mothers studied, 3.0% had a history of depression associated with HC use, and 9.8% had a history of depression not associated with HC use.

2. Women with a history of depression associated with HC use had a higher risk of postpartum depression (PPD) compared to those with prior non-HC-associated depression.

3. The crude odds ratio for PPD in women with HC-associated depression was 1.42, and the adjusted odds ratio was 1.35.

The findings of this study indicate that HC-associated depression may be an indicator of PPD susceptibility, offering a novel strategy in clinical PPD risk stratification. The study also suggests the existence of a hormone-sensitive subgroup of women who may be more vulnerable to depression during different phases of their reproductive life span.

“The study highlights the importance of healthcare providers taking a detailed reproductive history of women, including a history of HC use, to identify women who may be at higher risk of PPD. It underscores the need for further research into the relationship between hormonal changes and depression during different stages of a woman's reproductive life span,” added Dr. Søren Larsen the lead author of the study.

Reference:

Larsen SV, Mikkelsen AP, Lidegaard Ø, Frokjaer VG. Depression Associated With Hormonal Contraceptive Use as a Risk Indicator for Postpartum Depression. JAMA Psychiatry. Published online April 26, 2023. doi:10.1001/jamapsychiatry.2023.0807