Press Releases: National
September 27, 2007
Kaiser Permanente Study Shows One in Seven Women are Depressed Before, During, or After Pregnancy
OAKLAND, Calif. – A new Kaiser Permanente study, the first integrated survey of maternal depression, shows that more than one in seven women are depressed at some time during the nine months before becoming pregnant, during pregnancy, or in the nine months after childbirth. The study, which appears in the October 2007 issue of The American Journal of Psychiatry, also found that more than half of the women who experienced postpartum depression had also been depressed before becoming pregnant or during pregnancy.
"These findings show we need to pay more attention to depression before pregnancy," said Evelyn Whitlock, MD, MPH, senior investigator at the Kaiser Permanente Center for Health Research and co-author of the study. "Doctors and the public tend to focus more on postpartum depression because of the huge gap between a new mother's joyful expectations and the crushing reality of depression."
The consequences of postpartum depression, which affects 400,000 women in the United States, can be devastating. It can inhibit a woman's ability to bond with her infant, relate to the child's father, and perform daily activities.
"While postpartum depression clearly is an important concern," Whitlock added, "we also need to consider the mental health and treatment needs of the many women who are depressed right before or during their pregnancies."
Investigators at the Kaiser Permanente Center for Health Research profiled 4,398 women who gave birth between 1998 and 2001. They found that 8.7 percent were identified as depressed in the nine months before pregnancy, 6.9 percent during pregnancy, and 10.4 percent in the nine months following childbirth. A total of 15.4 percent – more than one in seven women – were depressed during at least one of these three periods. Nearly three-fourths of women with postpartum depression also were depressed before pregnancy, and more than half of the women depressed before pregnancy then became depressed during their pregnancy, the study found.
"The biggest news here is that we need to manage depression as a chronic condition in women of childbearing age, rather than assume depression is a temporary condition that can be either triggered or relieved by getting pregnant or giving birth," Whitlock said. "Women with a history of depression should be closely monitored for depressive symptoms during prenatal and postpartum care. And, given recent evidence showing that relapse of depression is twice as common in pregnant women with major depression who stop taking antidepressants after becoming pregnant as women who continue treatment, a choice of effective and safe treatment options for depressed pregnant women is very important."
The study also found that 93.4 percent of the women identified with depression before, during, or after pregnancy had a mental health visit or received antidepressants. Nearly three-fourths of depressed women received an antidepressant – 77 percent before pregnancy, 67 percent during pregnancy and 82 percent after delivery. Selective serotonin reuptake inhibitor antidepressants were the most common type of antidepressants prescribed, and 180 women (4 percent of all pregnant women) received them during pregnancy. The authors note that women received these medications before concerns were publicized about possible effects of SSRIs on persistent pulmonary hypertension in newborns and on cardiovascular malformations.
The study was funded by a contract from the Centers for Disease Control and Prevention. The contract as administered by America's Health Insurance Plans. The study's authors are affiliated with the Centers for Disease Control and Prevention or with Kaiser Permanente's Center for Health Research.
About the Kaiser Permanente Center for Health Research
Kaiser Permanente's Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has facilities in Portland, Ore., and Honolulu. Find out more through the center's website: http://www.kpchr.org/public/default.asp.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.