Postpartum%20depression Signs and Symptoms

• Perinatal depression is an episode of major or minor depression occurring during pregnancy (antenatal or antepartum period) and/or after giving birth (postnatal or postpartum period)

Postpartum Depression (PPD)

• Major depressive episode occurring within 4 weeks following delivery or up to a year after childbirth
• May peak at 2-4 weeks and 10-14 weeks after childbirth
• Prevalence rates are estimated between 6-13%
• Course varies with the symptoms spontaneously resolving weeks after its onset or may persist beyond the 1st postnatal year; may even relapse in either pregnant or non-pregnant state

• Symptoms are similar to those of major depression (eg irritability, anxiety, sleep disturbance) but with additional features distinctive of the postpartum period like feelings of being overwhelmed and inadequate as a parent, and being highly preoccupied with the baby’s feeding and health
  
  • Suicidal thoughts and infanticide have also been noted in severe cases

• Risk factors include family or personal history of anxiety and mood disorders, untreated anxiety and depression during pregnancy, and previous history of PPD

• Though the specific pathogenesis is unknown, contributing factors to the development of PPD may include the following:
  
  • Rapid decrease of reproductive hormone levels after delivery
  • Acute/chronic maternal health problems
  • Genetic factors (eg variants in the SLC6A4 gene encoding the serotonin transporter, and GR and CRHR1 genes encoding the glucocorticoid receptor and corticotropin-releasing hormone receptor)
  • Social factors (eg unintended pregnancy, stressful events during pregnancy or early puerperium, infant with health issues, low social support, family or relationship conflicts, history of violence or abuse with partner)