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Postpartum Depression

Postpartum depression (PPD) affects 10-20% of new mothers each year and can have short- and long-term negative consequences for both mother and child. PPD describes a range of depressive symptoms that can occur within the first year after giving birth. Symptoms range from mild to severe and include feelings of sadness, anxiety, irritability, fatigue and difficulty bonding with the infant. Left unrecognized and untreated, PPD can negatively impact the mother-child relationship and the child's development through insecure attachment and increased risk of abuse. It is important for pediatricians to screen for PPD during postpartum visits in order to provide education and referrals for treatment.

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Melanie Galedo
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64 views3 pages

Postpartum Depression

Postpartum depression (PPD) affects 10-20% of new mothers each year and can have short- and long-term negative consequences for both mother and child. PPD describes a range of depressive symptoms that can occur within the first year after giving birth. Symptoms range from mild to severe and include feelings of sadness, anxiety, irritability, fatigue and difficulty bonding with the infant. Left unrecognized and untreated, PPD can negatively impact the mother-child relationship and the child's development through insecure attachment and increased risk of abuse. It is important for pediatricians to screen for PPD during postpartum visits in order to provide education and referrals for treatment.

Uploaded by

Melanie Galedo
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Melanie A.

Galedo

BSN 12-D

Postpartum Depression

Postpartum depression (PPD) is a significant public health problem, each year affecting
10% to 20% of new mothers. Many of these women and their children experience short- and
long-term adverse consequences. Despite an increasing awareness of the effects of maternal
depression on children’s health and welfare, it remains unrecognized and poorly understood by
women and clinicians alike. Because pediatricians encounter mothers repeatedly during the
postpartum year, it is important that they recognize PPD and appropriately educate and refer
mothers for evaluation and treatment.

Definition

PPD describes a heterogeneous group of depressive symptoms and syndromes that


occurs during the first year following birth. The American Psychiatric Association Diagnostic and
Statistical Manual of Mental Health Disorders-IV (DSM IV) uses the term “postpartum” more
specifically to describe symptoms of major depressive disorder, bipolar disorder, or brief
psychotic disorder beginning within 4 weeks of delivery. The psychiatric postpartum experiences
usually are divided into three categories: “maternal blues,” PPD, and postpartum psychosis. The
DSM IV does not apply “postpartum” to other psychiatric illnesses. However, anxiety disorders,
such as panic, obsessive-compulsive disorder, and phobias, can have an initial onset or
exacerbation in the postpartum period.

Epidemiology

Maternal blues or postpartum mood reactivity is considered a “normal” emotional


experience for women in the immediate postpartum period. It is estimated that 50% to 80% of
new mothers experience transient symptoms of depressed mood, at times alternating with elated
moods, irritability, increased crying spells, and a sense of “unreality” during the first 10 days after
birth. These symptoms usually resolve without intervention. On the other end of the spectrum is
postpartum psychosis, a rare (1/1,000 live births) and serious event that generally occurs within
2 weeks of delivery and is considered a psychiatric emergency that requires immediate
psychiatric intervention. PPD falls in the middle, occurring in 10% to 20% of postpartum women
and presenting with a range of mild to severe depressive symptoms.

Almost 50% of PPD cases are continuations of depressive episodes that occur during or
before pregnancy. The incidence of new-onset cases of depression during the postpartum year
is estimated to be 15%. However, new-onset cases occur throughout the year; the peak
prevalence is at 10 to 14 weeks after delivery.

Clinical Aspects

It is important to recognize the range of severity and symptomatology that mothers who
have PPD can experience. PPD often is differentiated into major and minor depression. Most
women (70%) experience minor depression. Symptoms of PPD may include the full range of
emotional, cognitive, and neurovegetative symptoms of depression (Table 1). Women who have
PPD often experience a cognitive dissonance between being glad they have new infants and
not being able to enjoy their children. They may experience anxiety and obsessional thinking
that is focused on the welfare of the child and concerns about their parenting ability. Despite
what can be severe symptomatology, many women and clinicians do not identify these
symptoms as depression.

Expert opinions differ as to whether PPD symptoms are unique or “atypical” compared with
symptoms of depression in the general population. Some studies indicate that women who have
PPD report higher levels of somatic complaints and more irritability, anxiety, fatigue, and
depression than women who have depression not related to childbearing. Other studies have
found no difference in symptomatology between the two groups.

The effects of maternal depression can be severe and long-lasting. Infants of depressed
mothers may be at increased risk of child abuse and are more likely to exhibit insecure
attachment patterns. Many factors contribute to the effects of PPD on infant development. The
severity and duration of the condition as well as the stress of life events, maternal age, and
number of children, economic resources, and emotional support can influence maternal behavior
and its subsequent impact on infant development. Furthermore, maternal depression can affect
parenting behavior, parenting attitudes, maternal-infant interactions family dynamics, and marital
harmony/discord in a variety of ways.

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