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Premenstrual syndrome and dysphoric disorder as risk factors for postpartum depression
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. (Reproduktiv hälsa)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.ORCID iD: 0000-0002-4935-7532
2013 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, no 2, 178-184 p.Article in journal (Refereed) Published
Abstract [en]

Objective To investigate a possible association between postpartum depression and premenstrual symptoms. Design Population-based cohort. Setting University Hospital, Sweden. Population During one year, May 2006 to June 2007, all delivering women in the hospital were asked to participate. Methods The participating women answered three questionnaires, at five days, six weeks and six months postpartum, containing the Edinburgh Postnatal Depression Scale (EPDS) and questions assessing previous premenstrual symptoms, medical history and life style. Main outcome measures The woman's self-reported depressive case/control status, women with 12 or more points on the EPDS being considered as cases. Results Among the 2318 participating women, 7.1% had a history of premenstrual syndrome and 2.9% a history of premenstrual dysphoric disorder. Previous premenstrual syndrome/premenstrual dysphoric disorder was associated with self-reported postpartum depression at five days, six weeks and six months postpartum. After stratification for parity, the associations remained significant solely among multiparas. Conclusions There appears to be an association between a history of premenstrual symptoms and development of self-reported postpartum depression. Parity was identified as effect modifier. This finding is clinically important for health care professionals working in maternity care.

Place, publisher, year, edition, pages
2013. Vol. 92, no 2, 178-184 p.
Keyword [en]
Depression, postpartum, premenstrual
National Category
Psychiatry Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology; Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-170796DOI: 10.1111/aogs.12041ISI: 000313914200009PubMedID: 23157487OAI: oai:DiVA.org:uu-170796DiVA: diva2:509530
Available from: 2012-03-13 Created: 2012-03-13 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Biological and Psychosocial Aspects of Postpartum Depression
Open this publication in new window or tab >>Biological and Psychosocial Aspects of Postpartum Depression
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Postpartum depression (PPD) is one of the most common complications of childbirth around the world. Despite several studies on the underlying mechanisms, the pathophysiology remains elusive. The aims of this thesis were to assess possible associations between the risk for self reported PPD and serum levels of leptin, the season of delivery, the gender of the newborn, and the history of premenstrual symptoms, respectively.

A population based cohort of 2318 newly delivered women in Sweden were screened five days, six weeks and six months postpartum, using the Edinburgh Postnatal Depression Scale. This cohort comprised 60% of the total population, and the prevalence of self reported PPD was 11.1% six weeks after the delivery.

A negative association between leptin levels at delivery and self reported PPD at six weeks and six months postpartum was evident, even after adjusting for confounding factors. 

An increased risk for self reported PPD was noted among women delivering during the last three months of the year, compared to those giving birth in April through June. This is of clinical importance, since women delivering at the end of the year could benefit from a closer follow-up after delivery. 

Despite previous varying findings – depending on study population and consequently different cultural settings – in our study, no association between infant gender and self reported PPD could be detected at six weeks or six months postpartum. However, women giving birth to baby boys had a higher risk for postpartum blues.  

Lastly, an increased risk for self reported PPD among women with a history of premenstrual symptoms was noted. Interestingly, after stratification for parity, the association between PPD and premenstrual symptoms remained only among multiparas. The association between PPD and premenstrual symptoms might shed light on the many possible routes by which hormonal changes may influence mood in women.

In conclusion, this population based study strengthens the notion that PPD is a complex multifactorial disorder, with biological, social and psychological parameters shaping each individual’s risk.  Further research is needed in this field, in order to investigate underlying pathophysiological mechanisms, propose more effective diagnostic tests and assess therapeutic interventions.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 71 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 751
Keyword
Depression, postpartum, biological, seasonality, gender, premenstrual
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychiatry
Research subject
Psychiatry; Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-170818 (URN)978-91-554-8302-9 (ISBN)
Public defence
2012-05-11, Rosénsalen, Akademiska sjukhuset, ing 95/96, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Projects
UPPSAT
Available from: 2012-04-12 Created: 2012-03-13 Last updated: 2012-04-19

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Sylvén, Sara MEkselius, LisaSundström Poromaa, IngerSkalkidou, Alkistis

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