Major depression in new mothers peaks two weeks after birth

GPs are being urged to rollout early screening and intervention measures after a landmark study found the prevalence of major depressive disorder (MDD) is elevated during the entire peripartum period and highest two weeks after giving birth.
 
The largest mental health study of its kind used data from more than two million women and girls aged 10–59 across 90 countries.
 
Led by the University of Queensland (UQ), it found MDD impacts 6.2% of women and girls during pregnancy and 6.8% during the 12 months after childbirth, compared to 4.3% of women and girls in the broader population.
 
Prevalence of MDD increased to 8.3% at the end of the first two weeks after childbirth.
 
‘Our findings emphasise the need for increased integration of screening, prevention, and treatment of MDD during the peripartum period into existing models of care,’ the study concluded.
 
Lead author, UQ Honorary Associate Professor Alize Ferrari, said these treatments must become a routine part of maternity care.
 
‘The results highlight the need for including early screening and intervention for depression during the entire peripartum period, but especially in antenatal care visits with obstetricians, midwives and GPs, and other postpartum period health checks,’ she said.
 
According to a 2020 study, rates of perinatal mental health screening have improved significantly in Australia in recent years, with the percentage of women not screened decreasing from 40.6% in 2000 to 1.7% in 2017.
 
The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3% across the same period.
 
However, from 2013–17, women who were older or had reported emotional distress were less likely to have been screened both antenatally and postnatally.
 
Co-author UQ Adjunct Research Fellow Dr Paul Miller said variances in access to services, barriers to care, and cultural factors also play a significant role in screening.
 
‘How families, broader communities, and health systems support women and girls during pregnancy and in the months afterwards varies from country to country, and this plays a role in their mental health,’ he said.
 
‘The prevalence of major depression among women and girls living in the Australasia region was only slightly below the global average at 5.7% during pregnancy and 6.1% for the year after childbirth.
 
‘Our findings show the need for increased screening, prevention and treatment of major depression during pregnancy and the postpartum period.’
 
Globally, the study found MDD prevalence was highest in southern sub-Saharan Africa, ranging from 15.6% during pregnancy to 16.6% during the postpartum year, and south Asia, ranging from 13.7% during pregnancy to 14.6% during the postpartum year.
 
The prevalence was lowest in high-income Asia Pacific, ranging from 3.1% during pregnancy, to 3.3% during the postpartum year.
 
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depression major depressive disorder mental health pregnancy University of Queensland women’s health