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Women With Perinatal Depression May Have a Higher Mortality Risk, Study Finds
Women with perinatal depression could have an increased mortality risk, particularly due to suicide, regardless of pre-existing psychiatric disorders or familial factors, according to recent results from a matched cohort study published in The BMJ.
“Women affected by perinatal depression, their families, and health professionals, particularly those working in primary, maternal, and mental care, need to be aware of the serious health hazards regardless of psychiatric history,” authors noted. “Early detection and treatment are needed for groups at high risk of perinatal depression to prevent the fatal outcomes.”
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In this Swedish register-based study, researchers examined data on women who had (86,551) and women who hadn’t been diagnosed with perinatal depression (865,510), matched by age and delivery year, from January 1, 2001, to December 31, 2018. To address familial factors, comparisons were made with participants’ sisters (270,586) who either had (n = 24,473) or hadn’t been diagnosed with perinatal depression (n = 246,113) and who had at least 1 singleton birth during the study period. Authors used death by any cause as the main outcome measure, and multivariable Cox regression was employed to estimate hazard ratios for mortality, considering confounding factors.
A total of 522 deaths (0.82 per 1000 person years) were reported among women with perinatal depression over the follow-up. Women with perinatal depression were found to have an increased risk of death (adjusted hazard ratio (HR) = 2.11) when compared to women without perinatal depression. Risk of death seemed to increase more for postpartum than for antepartum depression (HR = 2.71 v 1.62), authors noted. A similar association was found for perinatal depression in the sibling comparison (HR = 2.12), especially in the first year after perinatal depression. An increased risk was associated with both unnatural and natural causes of death among women with perinatal depression (HR = 4.28 v 1.38), with the strongest association noted for suicide (HR = 6.34), although suicide was rare (0.23 per 1000 person years).
Authors noted that they may have missed women with mild to moderate perinatal depression who may not have sought medical treatment or been formally diagnosed, which could have limited results.
