WELLNESS
01/29/2015 08:16 am ET Updated Jan 30, 2015

Postpartum Depression Can Start As Soon As You're Pregnant

Jose antonio Sanchez reyes via Getty Images

Having a new baby is supposed to be a joyful experience -- but for many women, it comes with some significant mental health challenges.

While up to 70 percent of women report some experience of "baby blues" after giving birth, full-blown postpartum depression affects roughly 16 percent of new mothers.

But not all women experience postpartum depression the same way: In a recent study, researchers from the University of North Carolina identified three distinct subtypes of the disorder.

According to the study, some women experience the onset of depressive symptoms during pregnancy, which can result in a greater risk of developing the most severe type of postpartum depression after birth.

Dr. Samantha Meltzer-Brody of UNC's Perinatal Psychiatry Program said that it's important that doctors be aware of the various ways that postpartum depression presents itself.

"A thorough assessment of a women's history is necessary to guide appropriate clinical and treatment decisions," Meltzer-Brody said in a statement. "We now understand that postpartum depression can have onset of symptoms that may begin in pregnancy. Improved understanding of the differences in clinical presentation of postpartum depression impacts the implementation and interpretation of screening, diagnosis, treatment, and research of perinatal mood disorders."

The study analyzed data from more than 10,000 women collected during previous studies, using a common technique in psychiatry called latent class analysis. This statistical method is employed to create subgroups within a class, in this case, women with postpartum depression.

The researchers divided up women who suffered from postpartum depression into class 1, class 2 and class 3, looking specifically at severity of symptoms, timing of onset, suicidal ideation and anxiety. Class 1 had the least severe symptoms, followed by class 2 and so on. The third tier was heavily associated with onset of symptoms during pregnancy (rather than during the month following childbirth), as well as anxiety, poor mood, obstetric complications and suicidal ideation.

In addition to clinicians being knowledgeable about the various ways that postpartum depression presents itself, it's also important for expecting moths to be aware of the risk factors for developing this condition. It's long been known that women who have suffered from depression are at a higher risk for developing postpartum depression, in addition to younger women and women who have had children previously.

Recently, research has revealed other important and previously unknown risk factors for postpartum depression. Northwestern University research linked controlling the pain of childbirth and post-delivery to a reduced risk of developing postpartum depression. The study showed that postpartum depression rates were doubled for women who didn't have an epidural. A Finnish study also found that women diagnosed with fear of childbirth are at a three times higher risk of postpartum depression.

The research was present at a recent consortium event, Postpartum Depression: Action Towards Causes and Treatment (PACT), and published in the journal The Lancet Psychiatry.

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