Posted on Dec 02, 2020, 7 a.m.
About 5% of women report persistently high levels of postpartum depression symptoms for three years after giving birth. Longer screening periods after birth may be needed to help more women with postpartum depression find and get the treatment that they may need.
Many women develop symptoms of postpartum depression after giving birth. These include anxiety, sadness, difficulty sleeping, exhaustion, or disturbing thoughts.
Postpartum depression can make it difficult for new mothers to take care of themselves and their babies. But many women don’t recognize its symptoms, or don’t know that treatments are available.
Current guidelines recommend that pediatricians screen mothers for postpartum depression at their children’s well visits for up to 6 months after birth. Using pediatrician visits in this way may help identify more women with the condition and guide them to resources and treatment.
Postpartum depression isn’t the same for everyone. Researchers have found many differences in symptoms between individual women, as well as how early it starts and how long it lasts.
To better understand the different trajectories for postpartum depression, a research team led by Dr. Diane Putnick from NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) used data from a study that tracked more than 4,500 women and their children for 3 years after birth.
The study asked women about symptoms of postpartum depression 4 months and 1, 2, and 3 years after birth. The researchers also looked at factors that might influence the length or severity of postpartum depression. These included age, race, education, marital status, gestational diabetes or high blood pressure, and preexisting mental health conditions. Results were published on November 1, 2020, in Pediatrics.
The women’s experiences with postpartum depression fell into four main trajectories. In the most common, women had levels of symptoms that remained low over time. Almost three-quarters of the participants fell into this category.
A second group, making up 8% of participants, had low levels of symptoms at four months after birth that grew worse over time. Another 13% had moderate symptoms that decreased over time. And about 5% experienced high levels of depressive symptoms that stayed higher than the other groups, even years after giving birth in some women.
Women with a previous mood disorder diagnosis and those who experienced gestational diabetes were the most likely to fall into the group with persistently high symptoms. Women with persistently high symptoms were also more likely to be younger and have less education.
More work is needed to better understand the factors that influence the trajectory of postpartum depression for different women. Improved screening could eventually help doctors identify more women who are struggling with the condition.
“Our study indicates that six months may not be long enough to gauge depressive symptoms,” Putnick says. “These long-term data are key to improving our understanding of mom’s mental health, which we know is critical to her child’s well-being and development.”
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Trajectories of Maternal Postpartum Depressive Symptoms. Putnick DL, Sundaram R, Bell EM, Ghassabian A, Goldstein RB, Robinson SL, Vafai Y, Gilman SE, Yeung E. Pediatrics. 2020 Nov;146(5):e20200857. doi: 10.1542/peds.2020-0857. PMID: 33109744.