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Postpartum%20depression Signs and Symptoms
Definition
- 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
Signs and Symptoms
- 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
- Risk factors include family or personal history of anxiety and mood disorders, untreated anxiety and depression during pregnancy, and previous history of PPD
Etiology
- 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)
