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High risk of recurrent postpartum mental disorders
Clinical Question
What is the recurrence risk of postpartum mental disorders in affected women after subsequent deliveries?
Bottom line
The recurrence risk of postpartum mental disorders (PPMDs) in affected women after subsequent deliveries is substantial. At least 1 in 4 women with PPMDs after their first delivery will have a subsequent episode after their second delivery, and more than 1 in 2 women with PPMDs after both their first and second deliveries will have a subsequent episode after a third delivery. As noted, the case detection methodology used in this study may have missed women with milder cases of PPMDs that did not require psychotropic medications or those women treated only with psychotherapy. 1b
Reference
Study design: Cohort (retrospective)
Funding: Foundation
Setting: Population-based
Synopsis
These investigators analyzed data from multiple registries in Denmark to determine the recurrence risk of PPMD in women, aged 15 to 45 years, with a first live birth from January 1997 through December 2015 with no history of psychiatric disorders at the time of delivery. PPMDs were defined using standard international diagnostic criteria and identified based on treatment records from psychiatric care and psychotropic drug prescriptions within 6 months of delivery. As a result of this methodology, milder, untreated cases of PPMDs or PPMDs treated with psychotherapy alone may not have been detected. After the second delivery, the recurrence risk of a PPMD was 25.5% (95% CI 23.8% - 27.2%). After the third delivery, the recurrence risk was 56.8% (46l.8% - 65.6%).
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC