Family history of psychiatric illness doubles risk of Postpartum depression: JAMA

DENMARK: Women who had a family history of any psychiatric condition were nearly twice as likely to have post-natal depression than those who did not states a study published in the journal JAMA Psychiatry.

A frequent but serious psychological disorder is depression. According to research, depression may be influenced by genetic, biochemical, environmental, and psychological variables. Postpartum depression involves symptoms that are analogous to those of severe depression beyond the postpartum period and can vary from mild to severe bouts. Since postpartum depression is treatable and preventive, it is crucial to identify high-risk women early in order to stop or lessen the negative effects that are associated with PPD. There is conflicting data at this time about the link between postpartum depression and a family history of psychiatric problems. Familial risk of postpartum depression has been found in family research, although systematic reviews and umbrella reviews, which combine all risk variables for postpartum depression, frequently have not.

The authors of the study aimed to research the relationship between a family history of psychiatric problems and the likelihood of postpartum depression within a year following delivery.

The authors recommended that doctors take into account a family history of psychiatric problems when caring for their pregnant patients in light of their findings.

For this purpose, between September 2021 and March 2022, databases were searched for cohort and case-control studies that discussed the relationship between PPD and family history of any psychiatric disorder. The researchers found 26 studies comprising information on 1,00,877 women that matched the criteria for inclusion and determined that the strength of the evidence was moderate. The MOOSE checklist was used for reporting. The Newcastle-Ottawa Scale was used by two reviewers to independently extract predetermined data and determine the bias risk of eligible studies. In a meta-analysis, data were combined using a random-effects model. The combined link between postpartum depression and family history of psychiatric diseases served as the study's main finding.

Key findings of the research:

• Mothers with a family history of psychiatric illnesses had a higher OR of developing postpartum depression (OR, 2.08; 95% CI, 1.67-2.59; I2 = 57.14%), which is equivalent to a risk ratio of 1.79 (95% CI, 1.52-2.09).
• The odds of Postnatal depression were maximum during the initial 12 weeks after delivery (OR = 2.18) but they did not vary statistically from those in the 13–26 week (OR = 1.63) or the 27–52 week (OR = 1.35) or 52–52 week (OR = 1.35) postpartum intervals.
• When determining family history of psychiatric disorders using self-report rather than through validated tools or registries, the likelihood of PPD appeared to be higher.
• The results of the meta-regression, sensitivity, and subgroup analyses aligned with the findings of the main analysis.
• As per GRADE, the overall reliability of the findings was rated as moderate.

"Postpartum depression (PPD), one of the most prevalent problems associated to childbirth, affects 10% to 15% of expectant mothers, and is crucial for mothers, children, and families", asserted the authors.

The researchers concluded that mothers with a family history of any psychiatric condition are almost two times more likely to experience postpartum depression than mothers without such a history, according to evidence with a reasonable degree of certainty.

REFERENCE

Zacher Kjeldsen MM, Bricca A, Liu X, Frokjaer VG, Madsen KB, Munk-Olsen T. Family History of Psychiatric Disorders as a Risk Factor for Maternal Postpartum Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022 Aug 17. doi: 10.1001/jamapsychiatry.2022.2400. Epub ahead of print. PMID: 35976654.