Postpartum depression can start during pregnancy

"We now understand that postpartum depression can have onset of symptoms that may begin in pregnancy," says Samantha Meltzer-Brody. (Credit: Justin Fincher/Flickr)

Not all postpartum depression is the same. Researchers say there are three distinct subtypes based on symptoms, and it’s important for doctors to identify the specific type to tailor treatment.

In particular, women who experienced symptoms during pregnancy may be at risk for more severe postpartum depression than those whose symptoms begin after birth, researchers found.

“Clinicians should be aware of the diverse presentation of women with postpartum depression,” says Samantha Meltzer-Brody, director of the Perinatal Psychiatry Program at the UNC Center for Women’s Mood Disorders and corresponding collaborator of a new study published in The Lancet Psychiatry.

“A thorough assessment of a women’s history is necessary to guide appropriate clinical and treatment decisions,” Meltzer-Brody says. “We now understand that postpartum depression can have onset of symptoms that may begin in pregnancy.


“Improved understanding of the differences in clinical presentation of postpartum depression impacts the implementation and interpretation of screening, diagnosis, treatment, and research of perinatal mood disorders. We are now working to apply our findings from this work to future biological and genetic studies of depression in women across the perinatal period.”

The findings are from a new international research consortium called PACT (Postpartum Depression: Action Towards Causes and Treatment), which includes more than 25 investigators in seven countries.

In the new study, data from more than 10,000 women collected in previous studies were analyzed using a statistical technique called latent class analysis. This technique has been widely used in psychiatry and other medical disciplines and is considered appropriate for data that examines the presence or absence of symptoms.

The clinical characteristics found to be most relevant in defining the three subtypes were the timing of symptom onset (beginning during pregnancy or after birth), the severity of symptoms (including thoughts of suicide), a history of a previous mood disorder, and whether or not a woman had medical complications during pregnancy or childbirth.

Source: UNC-Chapel Hill