A new study finds that postpartum depression is a disorder that actually includes three distinct subtypes of clinical presentation.
Subtypes classification is determined by timing of symptom onset, severity of symptoms, history of mood disorders, and medical complication during pregnancy.
Saliently, each subtype of postpartum depression requires specific or tailored interventions for the best care.
Notably, some women may experience symptoms before birth and may be at risk for more severe postpartum depression than those whose symptoms begin after birth.
“Clinicians should be aware of the diverse presentation of women with postpartum depression,” said Samantha Meltzer-Brody, M.D., MPH, director of the Perinatal Psychiatry Program at the University of North Carolina’s Center for Women’s Mood Disorders.
Meltzer-Brody served as corresponding collaborator of the study, which is found in the journal The Lancet Psychiatry.
“A thorough assessment of a women’s history is necessary to guide appropriate clinical and treatment decisions,” Meltzer-Brody said.
“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.”
Researchers analyzed data collected by a new international research consortium called PACT (Postpartum Depression: Action Towards Causes and Treatment). The group includes more than 25 investigators in seven countries.
PACT members include investigators interested in mood disorders and/or perinatal mood disorders, with a focus on both the clinical symptoms and the underlying biological and genetic contributions of these disorders.
In the 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.
In particular, women who experienced symptoms during pregnancy may be at risk for more severe postpartum depression than those whose symptoms begin after birth, the researchers found.