Grand Rounds

The Four Maternal Characteristics that Predict Postpartum Depression Severity

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BACKGROUND AND PURPOSE:

  • Fisher et al. (Depression and Anxiety, 2019) sought to identify which characteristics can best predict postpartum depressive symptoms

METHODS:

  • Secondary data analysis from a randomized clinical trial (RCT)
    • Initial RCT looked at interventions for postpartum depression
      • Intervention was telephone-based care vs usual management
      • No differences in outcome were found
    • Women with a postpartum depressive disorder participated and completed symptom severity assessments at
      • 4-8 weeks (intake)
      • 3 months
      • 6 months
      • 12 months
    • Clinician interviews measured depressive symptom severity, medical and psychiatric history, assessment of function, obstetric experience, and infant status
    • Modeling was used to estimate group-based trajectories (patients’ clinical patterns or journeys)

RESULTS:

  • 507 women with postpartum depression were included
  • Analyses resulted in identification of three distinct clinical ‘trajectories’
    • Gradual remission (50.4%)
    • Partial improvement (41.8%)
    • Chronic severe (7.8%)
  • Key predictive characteristics of the chronic severe versus gradual remission and partial improvement trajectories included
    • Parity
    • Education
    • Baseline global functioning
    • Baseline depression severity (Edinburgh Postnatal Depression Scale ≥10)
  • Trajectory membership in the most severe group could be predicted in 72.8% (353/485) of women based on the above 4 characteristics

CONCLUSION:

  • Severity of postpartum depression could be predicted with 72.8% accuracy using 4 characteristics: parity, education, baseline global functioning and depression severity
  • Ability to predict severity grouping could lead to more targeted, individualized interventions

Learn More – Primary Sources:

Four maternal characteristics determine the 12-month course of chronic severe postpartum depressive symptoms.

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Related ObG Topics:

Screening for Perinatal Depression
Does Maternal Depression or Stress Affect Fetal Growth?
Managing Pain in the Postpartum Period: Recommendations Using the Multimodal Approach

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