Progression of major depression during pregnancy and postpartum: a preliminary study

Abstract

Objective: The purpose of this pilot study was to investigate major depressive symptoms among a high-risk group of pregnant women managed at a tertiary care setting.

Method: The study prospectively evaluated pregnant women who met DSM-IV criteria for a major depressive episode (MDE). Psychiatric measures for depression, anxiety and social impairment were administered at monthly intervals during pregnancy and immediate postpartum period.

Results: Twenty-four women provided longitudinal data from mid pregnancy to 2 months of postpartum period. 86% of women were clinically symptomatic at the beginning of study during pregnancy and only 32% remained clinically symptomatic at 2 months following delivery reaching. This difference reached a statistical significance level p < 0.001. Pregnant women with prior histories of major depression, comorbid anxiety disorder, histories of domestic violence, and those with uninvolved spouse or partners were more at-risk to be clinically symptomatic in the immediate postpartum period.

Conclusions: In a group consisting of largely Latina women at a tertiary care setting, progression of major depression when treated with antidepressant medication(s) is that of an improvement from pregnancy to immediate postpartum period. Further longitudinal studies are needed to assess impact of clinical characteristics and treatment on major depression in larger diverse obstetric group.

• Antidepressants
• depression
• postpartum
• pregnancy
• progression

Acknowledgements

Authors’ acknowledge John A. Rush, MD and Marlene P. Freeman, MD for their mentorship (for Dr. Shivakumar) during conceptualization and implementation of the study; Anna Brandon, PhD for her assistance in planning the study implementation; Parkland’s Obstetric-Psychiatric Clinic staff members-Eliot DeGravelles, MD, and Domingo Davila, MSW, and the Obstetric research staff (Lisa Moseley, RN, Ivette Ana Sias, Maria Garcia, and Ileana Gonzalez) for their assistance in the study enrollment. Finally, the authors’ extend their appreciation to the patients of the Parkland Obstetric-Complications’ Clinic for their generous participation in the study.