Women with unintended pregnancy are four times more likely to suffer from postpartum depression at twelve months postpartum, suggests a new study published today in BJOG: An International Journal of Obstetrics and Gynaecology.
The study, conducted at the University of North Carolina prenatal clinics questioned participants about pregnancy intention at 15-19 weeks gestational age, and women were classified as having an intended, mistimed or unwanted pregnancy. There were 433 women (64%) with an intended pregnancy, 207 (30%) with a mistimed pregnancy and 40 (6%) with an unwanted pregnancy. Unintended pregnancy was defined as both mistimed and unwanted pregnancies. Data were analysed for 688 women at three months and 550 women at twelve months.
Results show that postpartum depression was more likely in women with unintended pregnancies at both three months (11% vs. 5%) and twelve months (12% vs. 3%). The increased risk was highest at 12 months and indicates that this group of women have a long term risk of depression. When age, education level and poverty status were factored into the results, women with unintended pregnancy were still twice as likely to have postpartum depression at twelve months.
The authors conclude that unintended pregnancy may have a long term effect on maternal wellbeing and clinicians could consider pregnancy intention at antenatal visits and offer appropriate support both during and following the pregnancy.
Dr Rebecca Mercier, from the Department of Obstetrics and Gynaecology, University of North Carolina and co-author of the research said:
"While many elements may contribute to postpartum depression, the results of this study show that unintended pregnancy resulting in live birth could also be a contributing factor.
"Unintended pregnancy carried to term may have a long term effect on women. Healthcare professionals should therefore consider asking about pregnancy at early antepartum visits to screen for unintended pregnancy as women who report that their pregnancy was unintended or unwanted may benefit from earlier or more targeted screening both during and following pregnancy.
"Simple, low-cost screening interventions to identify women at risk could allow targeted intervention when appropriate and could potentially prevent complications from future unintended pregnancies."
Mike Marsh, BJOG Deputy Editor-in-chief said:
"Unintended pregnancy has been linked to poor prenatal care, high risk pregnancy behaviours, increased rates of preterm birth and low birth rate, poor social outcomes in childhood and increased medical costs.
"However, the relationship between unintended pregnancy and poor neonatal outcomes has been studied extensively, but less is known about the effect of unintended pregnancy carried to term on the woman herself. The findings of this study focus on the effects of unintended pregnancy on the mother and we can see a relationship between unintended pregnancy and postpartum depression."
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Mercier JR, Garret J, Thorp J. Pregnancy intention and postpartum depression: secondary data analysis from a prospective cohort. BJOG 2013; dx.doi.org/10.1111/1471-0528.12255