Pregnancy complications and their association with postpartum depression symptoms: a retrospective study

ABSTRACT

Objective

Postpartum depression affects around 17% of the women worldwide and has considerable implications for maternal and child health. While some risk factors have been identified, the association between pregnancy and delivery complications and postpartum depression is less well understood. This study aims to determine whether specific pregnancy complications are associated with risk of postpartum depression symptoms (PPDS).

Method

This study analysed a subset of variables collected as part of a larger study exploring pregnancy circumstances and maternal-foetal health outcomes. Mothers residing in Australia provided information on their biological children aged 3–13 years. Pregnancy complications were analysed using bivariate analyses and binary logistic regression.

Results

Mothers (N = 1,926) reported on N = 3,210 pregnancies (mean number of pregnancies = 1.27, SD = 0.97). At the time of childbirth, mothers were on average 30.1 years old (SD = 5.14). Experiencing a pregnancy complication increased the risk of PPDS (X² = 16.45, df = 1, p < 0.001) However, logistic regression analyses indicated an increased risk of PPDS was associated with the specific pregnancy complications of cytomegalovirus (AOR = 7.06, 95% CI[1.51,32.98]), emergency caesarean (AOR = 1.67, 95% CI[1.31,2.12]), foetal distress before birth (AOR = 1.49, 95% CI[1.16,1.91]), induced labour (AOR = 1.55, 95% CI[1.25,1.91]) and placenta previa (AOR = 2.60, 95% CI[1.44,4.71]).

Conclusion

Specific pregnancy complications were associated with PPDS, suggesting that some complications may pose a greater risk for PPDS than others. This study contributes to the growing understanding of peripartum risk factors for postpartum depression, and suggests that early clinical identification of at-risk mothers and early prophylactic and supportive care may be warranted to reduce that risk.

Key Points

What is already known about this topic:

1. Postpartum depression is a prevalent mental health condition affecting almost 1 in 5 mothers worldwide.

2. A complicated pregnancy and delivery experience is associated with an increased risk of adverse psychosocial outcomes, including postpartum depression.

3. Targeted interventions in the peripartum period for mothers identified to be at higher risk of postpartum depression may be effective at mitigating the impact.

What this topic adds:

1. Analysis of distinct and specific pregnancy complications against postpartum depression symptoms revealed that certain complications had a more significant impact than others in an Australia-based maternal cohort.

2. Emergency caesarean delivery, cytomegalovirus, foetal distress, induced labour, and placenta previa were significant predictors of postpartum depression symptom development.

3. Gestational diabetes, bleeding during pregnancy, low amniotic-fluid index, pre-eclampsia, and candida infections were not associated with postpartum depression symptoms in this study.

KEYWORDS:

• Postpartum depression
• pregnancy complications
• cytomegalovirus
• foetal distress
• emergency caesarean
• placenta previa

Acknowledgements

The authors thank the mothers who responded for their invaluable contribution to this study. Additionally, the first author would like to thank the Swinburne University School of Health Sciences Summer Research Internship program for their support and opportunity to participate in this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The de-identified data that support the findings of this study are available from the corresponding author (JB) upon reasonable request and following Swinburne University HREC ethical approval to do so.