Depression associated with hormonal contraception indicates risk for postpartum depression

Key takeaways:

• Women with depression associated with hormonal contraception more likely had postpartum depression.
• Study findings do not imply hormonal contraception increases risk for postpartum depression.

Depression associated with hormonal contraception may indicate susceptibility to postpartum depression, according to a study published in JAMA Psychiatry.

“The findings show that women with a history of depression associated with [hormonal contraception (HC)] initiation had a higher risk of developing a depressive episode during pregnancy and after childbirth compared with women with a history of depression not associated with HC initiation,” Søren Vinther Larsen, MD, from Copenhagen University Hospital, and colleagues wrote.

In a study of 188,648 first-time mothers, 5,722 (mean age, 26.7 years) had a history of depression associated with HC use and 18,431 (mean age, 27.1 years) had a history of depression not associated with HC.

The researchers found that women with depression associated with HC initiation had a higher risk for postpartum depression (PPD) than women with prior depression not associated with HC.

“This study provides evidence for the existence of a subgroup of women who are sensitive to hormonal transitions across the reproductive life span by showing that a history of depression coinciding with the initiation of HC may be associated with a higher risk of PPD beyond the risk of a history of depression not coinciding with HC initiation,” Larsen and colleagues wrote. “Importantly, the findings do not imply that HC use leads to a higher risk of PPD but do indicate that a history of HC-associated depression may unmask PPD susceptibility, which may prove useful as a clinical tool in PPD risk stratification.”