Postpartum Depression in Women with the FMR1 Premutation

Background: Psychiatric disorders in women with the FMR1 premutation are common and include attention deficit hyperactivity disorder, anxiety, depression, and eating disorders. This pilot study explored the risk factors for postpartum depression (PPD) in women with the premutation. Methods: We conducted a chart review of 50 women premutation carriers with major depressive disorder who had children. Of these, 7 women had a history of major depressive episodes in the postpartum period. The PPD and non-PPD groups were characterized descriptively based on women's age at the time of the psychiatric evaluation, race, ethnicity, education level, IQ, CGG repeat size, comorbid psychiatric conditions, parity, and number of children with fragile X syndrome (FXS). Exact logistic regression was used to analyze the relationship between the number of children with FXS and the risk of PPD. Results: The PPD and non-PPD groups were similar on all variables examined, with the exception of the number of affected children. Each of the 7 women with PPD had at least one child with FXS, whereas a third of the women without PPD had no affected children. For each additional affected child, the risk of PPD increased by 158% (exact odds ratio 2.58, 95% CI 0.99-7.59). Further studies are needed to replicate these findings and to better characterize PPD in female premutation carriers.