• J A Kountanis, M Muzik, T Chang, E Langen, R Cassidy, G A Mashour, and M E Bauer.
• Department of Anesthesiology, Michigan Medicine, 1500 E Medical Center Dr, MI, USA; Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E Medical Center Dr, MI, USA. Electronic address: kountani@med.umich.edu.
• Int J Obstet Anesth. 2020 Nov 1; 44: 90-99.

BackgroundThis study aims to investigate the relationship between the birth experience and the risk of developing postpartum depression or post-traumatic stress disorder.MethodsIn this prospective, longitudinal, observational study, women were assessed at different time points for depression and post-traumatic stress disorder. The risk of depression or post-traumatic stress disorder based on patient characteristics and specific birth events was assessed within three months postpartum.ResultsWe enrolled 600 women; 426 were eligible for postpartum assessment. At six weeks and three months postpartum, 15.9% and 12.7% screened positive for depression respectively. Positive post-traumatic stress disorder screenings at six weeks and three months postpartum were 6.2% and 5.1% respectively. Twenty-seven women (8.3%) with a negative screening at six weeks converted to a positive depression or post-traumatic stress disorder screening at three months. A pre-existing history of anxiety or depression was associated with an increased risk of developing depression (aOR 2.12, 95% CI 1.30 to 3.47) and post-traumatic stress (aOR 3.15, 95% CI 1.42 to 7.02) within three months postpartum. The risk of developing post-traumatic stress disorder within three months postpartum was also increased among patients experiencing their first delivery (aOR 2.55, 95% CI 1.10 to 5.88) or operative management of postpartum hemorrhage (aOR 4.44, 95% CI 1.16 to 17.02).ConclusionDepression and post-traumatic stress symptoms either persisted or had new onset at three months postpartum. Mental health screening and postpartum follow-up after six weeks should be considered in high-risk patients who have a history of psychopathology, nulliparity, or undergo operative management of postpartum hemorrhage.Copyright © 2020 Elsevier Ltd. All rights reserved.

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