Family history of psychiatric disorder nearly doubles postpartum depression risk

Women who had a family history of any psychiatric disorder were almost twice as likely to experience postpartum depression compared with women who had no history, according to a meta-analysis published in JAMA Psychiatry.

“The postpartum period is critical for mothers, children and families, and approximately 10% to 15% of new mothers experience postpartum depression (PPD), one of the most common complications related to childbirth,” Mette-Marie Zacher Kjeldsen, MSc, a PhD student at Aarhus University’s National Centre for Register-based Research in Denmark, and colleagues wrote. “PPD ranges from mild to severe episodes and includes similar symptoms as major depression outside the postpartum period. PPD is preventable and treatable, and therefore, early identification of women at high risk is important to prevent or mitigate the detrimental consequences observed in relation to PPD.”

Zacher Kjeldsen and colleagues searched databases in September 2021 and March 2022 for cohort and case-control studies that reported on the association between family history of any psychiatric disorder and PPD. Twenty-six studies met the inclusion criteria, which the researchers deemed had moderate certainty of evidence.

In the primary analysis of 100,877 women, Zacher Kjeldsen and colleagues found that women with a family history of psychiatric disorders had significantly higher odds of PPD compared with those who did not have a history of psychiatric disorders in their family (OR = 2.08; 95% CI, 1.67-2.59). This corresponded with a relative risk of 1.79 (95% CI, 1.52-2.09).

The researchers also examined the likelihood of PPD by time point after delivery. The odds of PPD were highest within the first 12 weeks postpartum (OR = 2.18; 95% CI, 1.69-2.81), but they were not statistically different from the odds of PPD between 13 and 26 weeks (OR = 1.63; 95% CI, 1.18-2.25) or between 27 and 52 weeks (OR = 1.35; 95% CI, 0.74-2.49). Further evaluation of the association between PPD and family psychiatric history during these periods revealed that the odds of PPD “seemed higher when family history of psychiatric disorders was self-reported compared with when ascertained through validated instruments or registries,” they wrote. “However, as only few studies used validated instruments (n = 2) and registries (n = 1), the accuracy of these results is limited.”

Based on their findings, Zacher Kjeldsen and colleagues suggested clinicians consider family history of psychiatric disorders when providing their pregnant patients care.

“Information on family history of psychiatric disorders is easy to identify through simple self-reported question(s), potentially as part of routine perinatal care, and early identification makes timely and targeted intervention possible to prevent PPD or mitigate the consequences thereof,” they wrote.