Faculty Mentor
David Jackson
Major/Area of Research
Physician Assistant Studies
Description
Background: Postpartum depression (PPD) affects 10-20% of women in the US. It is a condition in which mothers’ experience depression during pregnancy or within 4 weeks postpartum. Numerous physiological, socio-economic, and psychological factors have been linked to postpartum depression. Mothers with postpartum depression can experience feelings of (a) extreme sadness, (b) anxiety, and (c) exhaustion that may make it difficult for them to complete activities of daily living for themselves or for others. PPD in its severest form can lead to suicide and acts of harming the newborn.
Methodology: Information was gathered using the search engines: (a) Pubmed, (b) PubMed Central, and (c) Google scholar. The terms used in the search were: (a) Postpartum Depression AND Risk Factors, (b) Postpartum Depression AND Epidemiology, (c)Postpartum Depression AND Pathophysiology, and (d) Postpartum depression treatment, specifically articles published between the years of 2013 and 2018, in English.
Results: The literature search on postpartum depression yielded information on the (a) risk factors, (b) epidemiology, (c) pathophysiology, and (d) treatment options relating to this population. Significant risk factors include: (a) women over the age of 30, (b) psychological, physical, or sexual abuse, (c) low socioeconomic status, and (d) unplanned pregnancy. PPD has also been linked to physiologic changes in new mothers including (a) altered maternal brain responses (b) hormonal fluctuations, and (c) effects on immunity. Additionally, women with (a) poor marital relationship, (b) stressful life events, and (c) poor physical health/body image have been found to be of greater risk for PPD. Signs and symptoms of PPD include: (a) mood swings, (b) suicidal thoughts, (c) thoughts of harming the newborn, (d) insomnia, and (e) feelings of helplessness. PPD prevalence varies by state and can be as high as 1 in 5 women. PPD may resolve spontaneously within weeks after its onset; however, about 20% of women will continue to have depression up to one year following delivery, and about 13% after 2 years. Approximately 40% of women will have a relapse of their symptoms with subsequent pregnancies. Within the population of those identified at risk for PPD, only about half had undergone previous screening by a clinician since the birth of the child. Screening tests found to be valid for identification of at-risk mothers include the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9). Effective treatments have been found to include counseling, such as Cognitive Behavior Therapy, and antidepressant medication.
Conclusion: Without treatment, PPD can have detrimental effects on the health and welfare of the mother and child. Immediate family should be educated on the signs and symptoms of PPD. New mothers should be assisted with childcare activities and housekeeping responsibilities. Clinicians should screen and frequently follow up with patients that have established PPD. Assessments should include: (a) past psychiatric problems, (b) social stressors, and (c) biochemical changes. Treatment options include: (a) counseling, (b) group therapy, (c) hormonal therapy, (d) antidepressant medications, or (e) any combination therapy. These interventions have the potential to improve the detection and management of PPD.
Included in
Postpartum Depression
Background: Postpartum depression (PPD) affects 10-20% of women in the US. It is a condition in which mothers’ experience depression during pregnancy or within 4 weeks postpartum. Numerous physiological, socio-economic, and psychological factors have been linked to postpartum depression. Mothers with postpartum depression can experience feelings of (a) extreme sadness, (b) anxiety, and (c) exhaustion that may make it difficult for them to complete activities of daily living for themselves or for others. PPD in its severest form can lead to suicide and acts of harming the newborn.
Methodology: Information was gathered using the search engines: (a) Pubmed, (b) PubMed Central, and (c) Google scholar. The terms used in the search were: (a) Postpartum Depression AND Risk Factors, (b) Postpartum Depression AND Epidemiology, (c)Postpartum Depression AND Pathophysiology, and (d) Postpartum depression treatment, specifically articles published between the years of 2013 and 2018, in English.
Results: The literature search on postpartum depression yielded information on the (a) risk factors, (b) epidemiology, (c) pathophysiology, and (d) treatment options relating to this population. Significant risk factors include: (a) women over the age of 30, (b) psychological, physical, or sexual abuse, (c) low socioeconomic status, and (d) unplanned pregnancy. PPD has also been linked to physiologic changes in new mothers including (a) altered maternal brain responses (b) hormonal fluctuations, and (c) effects on immunity. Additionally, women with (a) poor marital relationship, (b) stressful life events, and (c) poor physical health/body image have been found to be of greater risk for PPD. Signs and symptoms of PPD include: (a) mood swings, (b) suicidal thoughts, (c) thoughts of harming the newborn, (d) insomnia, and (e) feelings of helplessness. PPD prevalence varies by state and can be as high as 1 in 5 women. PPD may resolve spontaneously within weeks after its onset; however, about 20% of women will continue to have depression up to one year following delivery, and about 13% after 2 years. Approximately 40% of women will have a relapse of their symptoms with subsequent pregnancies. Within the population of those identified at risk for PPD, only about half had undergone previous screening by a clinician since the birth of the child. Screening tests found to be valid for identification of at-risk mothers include the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9). Effective treatments have been found to include counseling, such as Cognitive Behavior Therapy, and antidepressant medication.
Conclusion: Without treatment, PPD can have detrimental effects on the health and welfare of the mother and child. Immediate family should be educated on the signs and symptoms of PPD. New mothers should be assisted with childcare activities and housekeeping responsibilities. Clinicians should screen and frequently follow up with patients that have established PPD. Assessments should include: (a) past psychiatric problems, (b) social stressors, and (c) biochemical changes. Treatment options include: (a) counseling, (b) group therapy, (c) hormonal therapy, (d) antidepressant medications, or (e) any combination therapy. These interventions have the potential to improve the detection and management of PPD.