from the February 22, 2010 issue of Connect

Increased Risk of Postpartum Depression for Mothers with Preterm and Low-Birth-Weight Infants

Dr. Simone Vigod

While much is known about the risk factors for postpartum depression (PPD) in women who carry their infants to term, medical experts are now looking at its effects on mothers who have preterm or low-birth-weight babies.

The results of a recent literature review found that mothers of preterm infants are at higher risk of depression than mothers of term infants in the immediate postpartum period, with continued risk throughout the first year for mothers of very-low-birth-weight infants.

Published in the January 2010 issue of the British Journal of Obstetrics and Gynaecology (BJOG), the research was led by Dr. Simone Vigod, psychiatrist with the Reproductive Life Stages Program, part of the Women’s Mental Health Program at Women’s College Hospital and scientist-in-training at the Women’s College Research Institute.  Colleagues Cindy-Lee Dennis, PhD at the University of Toronto and Lori Ross, PhD and Laura Villegas, both from the Centre for Addiction and Mental Health were co-authors of the study.

According to the review, which looked at 26 articles for a total of 2,392 mothers of preterm infants, rates of postpartum depression were as high as 40 per cent in the early postpartum period among women with premature infants, compared with approximately 10 to 15 per cent of women with term infants.  

Stress and anxiety might be expected in any new mother, but Dr. Vigod explains how to differentiate between what’s normal and what’s not.

“It comes down to the degree to which symptoms are impairing a woman’s ability to function normally,” she says. “Sustained low mood, an inability to eat or sleep, or excessive feelings of guilt and incompetence would suggest that the patient is suffering from PPD.”

Although the exact cause of PPD is unknown, it is believed that depression or anxiety during pregnancy, personal and/or family history of depression, a lack of social support and stressful life events are major contributing factors.

“It is very important that women with preterm infants who are experiencing depressive symptoms be assessed by mental health professionals,” adds Dr. Vigod. “PPD has serious implications for both the mother and baby, so monitoring maternal mental health is crucial.”

PPD can interfere with maternal-infant bonding, leading to attachment insecurity, developmental delay and social interaction difficulties in children of affected mothers.

The investigators are calling for further research to better understand how the degree of neonatal illness might mediate the risk for PPD in mothers of preterm infants.