Marie-Louise H. Rasmussen
Epidemiologist
Title: Postpartum antidepressant treatment in women with no prior psychiatric history: risk, duration of treatment, and recurrence risk
Biography
Biography: Marie-Louise H. Rasmussen
Abstract
Objective: 5-15% of all women experience postpartum depression (PPD), which for many is their first psychiatric disorder. The trajectory is likely very different compared to women with previous psychiatric disorders. We therefore estimated the incidence of postpartum antidepressant treatment, duration of treatment, and rate of subsequent postpartum antidepressant treatment and other depressive episodes in a nation-wide cohort of women with no prior psychiatric history. Method: We constructed a nation-wide cohort of 332,393 primiparous mothers with first birth from 1996-2008 (a total of 570,838 births) and no prior psychiatric hospital contacts and/or use of antidepressants. These were followed from 1996-2009. Postpartum antidepressant treatment (AT) was defined as use of antidepressants and/or hospital contact for PPD within six months after child-birth. Results: We observed 2,985 (0.5%) postpartum episodes of AT. One year after first treatment episode 28.5% were still in treatment; after four years 5.9%. After adjusting for year of birth and mothers age, women with a postpartum medication AT after their first birth had a 28.4 times higher rate (95% CI=21.4-37.7), and women with PPD hospital contact after first birth had a 54 times higher rate (95% CI=32.9-88.4) of a recurrent postpartum episode after their second birth compared to women with no postpartum AT history. Conclusions: 0.5 percent of women with no prior psychiatric history received AT after childbirth. They were characterized by a relatively short treatment regime, but a notably high rate of later AT and recurrent episodes of postpartum AT.