Kaiser Permanente Study Shows One In Seven Women Are Depressed Before, During, Or After Pregnancy

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 (SSRIs) 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 Kaiser Permanente



Kaiser Permanente is America's leading integrated health plan. Founded
in 1945, it is a not-for-profit; group practice prepayment program
headquartered in Oakland, Calif. Kaiser Permanente serves the health care
needs of more than 8.7 million members in nine states and the District of
Columbia. Today it encompasses the not-for-profit Kaiser Foundation Health
Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the
for-profit Permanente Medical Groups. Nationwide, Kaiser Permanente
includes approximately 156,000 technical, administrative and clerical
employees and caregivers, and more than 13, 000 physicians representing all
specialties. For more Kaiser Permanente news, visit the KP News Center at:
xnet.kp/newscenter.



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: kpchr/public/default.asp.


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