More than one in seven women are depressed at some time during the nine months before becoming pregnant, during pregnancy, or in the nine months after childbirth, a new Kaiser Permanente study shows.
The study, which appears in the October issue of The American Journal of Psychiatry, also found that more than half of the women who experienced postpartum depression had also been depressed before becoming pregnant or during pregnancy.
“These findings show we need to pay more attention to depression before pregnancy,” said Dr. Evelyn Whitlock, senior investigator at the Kaiser Permanente Center for Health Research and co-author of the study, in a news release. “Doctors and the public tend to focus more on postpartum depression because of the huge gap between a new mother’s joyful expectations and the crushing reality of depression.”
Postpartum depression, which affects 400,000 women in the United States, can inhibit a woman’s ability to bond with her infant, relate to the child’s father, and perform daily activities, the authors wrote.
“While postpartum depression clearly is an important concern,” Whitlock continued, “we also need to consider the mental health and treatment needs of the many women who are depressed right before or during their pregnancies.”
Researchers profiled 4,398 women who gave birth between 1998 and 2001. They found that 8.7 percent were identified as depressed in the nine months before pregnancy, 6.9 percent during pregnancy, and 10.4 percent in the nine months following childbirth.
A total of 15.4 percent — more than one in seven women — were depressed during at least one of these three periods. Almost 75 percent of the women with postpartum depression also were depressed before pregnancy, and more than half of the women depressed before pregnancy then became depressed during their pregnancy, the study found.
The study also showed that 93.4 percent of the women identified with depression before, during, or after pregnancy had a mental health visit or received antidepressants. The majority of depressed women received an antidepressant — 77 percent before pregnancy, 67 percent during pregnancy and 82 percent after delivery.
Selective serotonin reuptake inhibitor antidepressants (SSRIs), such as Prozac and Paxil, were the most common type of antidepressants prescribed, and 180 women (4 percent of all pregnant women) received them during pregnancy.
The authors said the women received these medications before concerns were publicized about possible effects of SSRIs on persistent pulmonary hypertension in newborns and on cardiovascular malformations.
"The biggest news here is that we need to manage depression as a chronic condition in women of childbearing age, rather than assume depression is a temporary condition that can be either triggered or relieved by getting pregnant or giving birth,” Whitlock said. “Women with a history of depression should be closely monitored for depressive symptoms during prenatal and postpartum care."