The clinical utility of maternal self-reported personal and familial psychiatric history in identifying women at risk for postpartum depression

Background. To determine whether maternal self-reported data on personal and family psychiatric history would significantly predict postpartum depressive symptomatology at 8 weeks postpartum and to examine which of these variables were the most predictive for inclusion in an obstetrical clinical assessment aimed at early identification of postpartum depression. Methods. As part of a longitudinal study, a population-based sample of 622 women completed mailed questionnaires at 1 and 8 weeks postpartum. Results. At 8 weeks postpartum, mothers who indicated that they had any personal psychiatric history were almost four times more likely to exhibit depressive symptomatology (Edinburgh Postnatal Depression Scale score >9) than those with no previous mental health difficulties (odds ratio [OR] 3.65, 95% CI 2.30-5.82). Any family psychiatric history was not a significant risk factor. Variables most predictive of depressive symptomatology at 8 weeks, explaining 42% of the variance, included: maternal antenatal depression (OR 3.77, p = 0.03), maternal history of postpartum depression (OR 2.21, p = 0.02), and Edinburgh Postnatal Depression Scale score > 9 at 1 week postpartum (OR 18.23, p <0.001). Conclusions. The results suggest that maternal variables, particularly those related to the index and past pregnancies, not family psychiatric history, are the best predictors of postpartum depressive symptoms. These findings highlight the importance of assessing symptoms of depression and anxiety during pregnancy and the early postpartum period, in order to facilitate timely identification of women at risk for developing postpartum depression.