TY - JOUR

T1 - Endocrine disease history and the risk of postpartum depression

AU - Rasmussen, Marie-Louise H.

AU - Poulsen, Gry J.

AU - Videbech, Poul

AU - Wohlfahrt, Jan

AU - Melbye, Mads

PY - 2023

Y1 - 2023

N2 - BackgroundPrevious research has suggested that some women are at increased risk of postpartum depression (PPD) because of an extra sensitivity to fluctuating hormones before and after parturition. This may particularly apply to women with endocrine disease, characterised by a less than optimal capability to self-regulate the hormonal feedback system. AimsTo investigate if women with endocrine disease history are at increased risk of developing PPD. MethodBased on information from Danish national registers, this nationwide cohort study included 888 989 deliveries (1995-2018). Endocrine disease history was defined as thyroid disease, pre-pregnancy diabetes, polycystic ovary syndrome and/or previous gestational diabetes within 10 years before pregnancy start. PPD was defined as use of antidepressants and/or hospital contact for depression within 6 months after childbirth. ResultsAmong 888 989 deliveries, 4.1% had a history of endocrine disease and 0.5% had a PPD episode. Overall, women with an endocrine disease history had a 42% (risk ratio 1.42, 95% CI 1.24-1.62) higher risk of PPD when compared with women with no endocrine disease. However, we also found the reverse association, whereby women with a PPD history had a 50% (hazard ratio 1.5, 95% CI 1.4-1.6) higher risk of endocrine disease when compared with women with no PPD history. ConclusionsWomen with endocrine disease history had a 40% higher risk of PPD compared with women with no endocrine disease. More attention should be given to pregnant women with endocrine disease history to increase awareness of early signs of PPD. The bi-directionality of the association points to a common underlying factor.

AB - BackgroundPrevious research has suggested that some women are at increased risk of postpartum depression (PPD) because of an extra sensitivity to fluctuating hormones before and after parturition. This may particularly apply to women with endocrine disease, characterised by a less than optimal capability to self-regulate the hormonal feedback system. AimsTo investigate if women with endocrine disease history are at increased risk of developing PPD. MethodBased on information from Danish national registers, this nationwide cohort study included 888 989 deliveries (1995-2018). Endocrine disease history was defined as thyroid disease, pre-pregnancy diabetes, polycystic ovary syndrome and/or previous gestational diabetes within 10 years before pregnancy start. PPD was defined as use of antidepressants and/or hospital contact for depression within 6 months after childbirth. ResultsAmong 888 989 deliveries, 4.1% had a history of endocrine disease and 0.5% had a PPD episode. Overall, women with an endocrine disease history had a 42% (risk ratio 1.42, 95% CI 1.24-1.62) higher risk of PPD when compared with women with no endocrine disease. However, we also found the reverse association, whereby women with a PPD history had a 50% (hazard ratio 1.5, 95% CI 1.4-1.6) higher risk of endocrine disease when compared with women with no PPD history. ConclusionsWomen with endocrine disease history had a 40% higher risk of PPD compared with women with no endocrine disease. More attention should be given to pregnant women with endocrine disease history to increase awareness of early signs of PPD. The bi-directionality of the association points to a common underlying factor.

KW - Depressive disorders

KW - epidemiology

KW - neuroendocrinology

KW - perinatal psychiatry

KW - antidepressants

KW - WOMEN

KW - NEUROBIOLOGY

KW - ESTROGEN

KW - STRESS

U2 - 10.1192/bjp.2022.173

DO - 10.1192/bjp.2022.173

M3 - Journal article

C2 - 36539281

VL - 222

SP - 119

EP - 124

JO - The Journal of mental science

JF - The Journal of mental science

SN - 0960-5371

IS - 3

ER -