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Elizabeth M. Whitehorn, Director

Risk Factors Associated with Perinatal Depression

There are identifiable risk factors commonly associated with perinatal depression. These risk factors, or combinations of risk factors, serve as predictors of who may be at risk of depression. Even in the absence of these risk factors, administration of a screening instrument, such as the Edinburgh Postnatal Depression Scale (EPDS), is encouraged.

Significant Predictors for Perinatal Depression

  • Prenatal depression
  • Child care stress
  • Life stress
  • Poor social support
  • Prenatal anxiety
  • Poor marital relationship
  • History of previous depression
  • Difficult infant temperament
  • Maternity blues
  • Single marital status
  • Previous postpartum depression
  • Severe premenstrual syndrome (PMS)
  • Family history of depression
  • Taking excessive sick leave during pregnancy
  • Frequent visits to doctor during pregnancy
  • Bereavement
  • Prior stillborn

Other Predictors for Perinatal Depression

  • Difficult family relationships
  • Work stress/new job
  • Severe financial difficulties
  • Recent stressful events
  • Victim of violence or abuse
  • Low confidence as a parent
  • Family history of postpartum depression
  • Teen or adolescent
  • Complicated or difficult pregnancy
  • Thyroid problems or family history of thyroid problems
  • Poor diet or severe morning sickness
  • Oral-contraceptive use or Depo-Provera shot soon after delivery
  • Early or recent loss of a parent
  • Other psychiatric disorders
  • Excessive lability of mood during pregnancy
  • Transient baby blues syndrome symptoms during first ten postpartum days

References:

  • Beck CT. Predictors of Postpartum Depression: An Update. Nurs Res. 2001;50;275-285

  • Beck, CT. Revision of the Postpartum Depression Predictors Inventory. JOGNN. 2001. Vol. 31

  • Kleiman, Karen. Could I Have Postpartum Depression? The Postpartum Stress Center Web site.

  • Lembke, Anna. A Psychosocial Approach to Postpartum Depression. Psychiatric Times, June 2002; Vol. XIX, Issue 6.

  • Misri, S. A Review of Screening Tools. Well Mother Web site.

  • Misri, S. Postpartum depression: Is there an Andrea Yates in your practice? Current Psychiatry Online. 2002; Vol 1., No 5

  • Misri, S., Duke, M. Depression During Pregnancy and Postpartum. Journal of the Society of Obstetrics & Gynecology of Canada 1995; 17:657-665

  • Nielsen, F., Videbech, P., Hedegaard, M. Postpartum depression: identification of women at risk. BJOB, 2000. Oct; 107(10): 1210-7

  • Pavlovich-Danis, SJ. When “Can Do” Fades to “Why Bother”: Understanding Depression in Women. Nursing Spectrum: 2004, June 1

  • Watt, Sword, Krueger, Sheehan. A cross-sectional study of early identification of postpartum depression: Implications for primary care providers from The Ontario Mother & Infant Survey. BMC Family Practice. 2002, 3:5