Women at risk of developing postpartum psychosis need close monitoring, says new review

There are clear risk factors for postpartum psychosis that all women should be asked about antenatally to ensure early recognition and prompt treatment of the condition, says a new review published today (12 July) in The Obstetrician & Gynaecologist (TOG).

Postpartum psychosis is a severe mental illness with a dramatic onset shortly after childbirth, affecting approximately 1-2 in 1000 deliveries. However, the review notes that the true incidence may be higher.

Common symptoms include; mania, severe depression, delusions and hallucinations, confusion, bewilderment or perplexity, all of which increase the risk for both mother and child.

The review notes that there is consistent evidence of a specific relationship between postpartum psychosis and bipolar disorder. Women with bipolar disorder have at least a 1 in 4 risk of suffering postpartum psychosis. Genetics are also a factor and with and a personal or family history of postpartum psychosis are at particularly high risk with greater than 1 in 2 deliveries affected by postpartum psychosis.

However, half of women who develop postpartum psychosis have no family history or previous that put them in a high risk group of suffering from the condition.

The review emphasises the need for close contact and review from a multidisciplinary team during the perinatal period for at least three months following delivery, even if the woman is well and recommends a written plan covering pregnancy and the postnatal period which should be discussed with the woman and her family.

Dr Ian Jones, Reader in Perinatal Psychiatry, Cardiff University and co-author of the review said:

"Women at high risk of postpartum psychosis need very careful care before conception, throughout pregnancy and during the postpartum period, including pre-conception counselling and close monitoring and psychiatric assessment after childbirth.

"Postpartum psychosis is a true psychiatric emergency and it is vital that is recognised early and treated immediately. Admission to hospital is usually necessary and women should ideally be offered a specialist mother and baby unit where the best treatment options can be established."

Jason Waugh, TOG's Editor-in-chief said:

"This review emphasises the importance of women at of postpartum psychosis as well as the early recognition and prompt treatment of women who develop the condition.

"This paper also underlines that half of women who experience postpartum psychosis have no previous risk factors. It is therefore vital that all women are made aware of the condition and its signs and symptoms."

More information: Di Florio A, Smith S, Jones I. Postpartum psychosis. The Obstetrician & Gynaecologist 2013; dx.doi.org/10.1111/tog.2041

add to favorites email to friend print save as pdf

Related Stories

Urinary incontinence doubles risk of postpartum depression

Jun 20, 2011

Women with urinary incontinence after giving birth are almost twice as likely to develop postpartum depression as those without incontinence, according to a new study led by Wendy Sword, a professor in McMaster University's ...

Lawson researcher sings the baby blues

Aug 22, 2012

The impact of bipolar disorder during pregnancy has been hotly contended among the research community. Now, a new study from Lawson Health Research Institute and Western University is sorting out the debate and calling for ...

Recommended for you

What sign language teaches us about the brain

2 hours ago

The world's leading humanoid robot, ASIMO, has recently learnt sign language. The news of this breakthrough came just as I completed Level 1 of British Sign Language (I dare say it took me longer to master signing ...

Why do men prefer nice women?

2 hours ago

People's emotional reactions and desires in initial romantic encounters determine the fate of a potential relationship. Responsiveness may be one of those initial "sparks" necessary to fuel sexual desire and land a second ...

Study reveals how to be socially successful

2 hours ago

Romantic, personal and professional relationships are fraught with danger, but a University of Queensland researcher has found the secret to interacting successfully with others in such settings.

User comments