The risk factors for postpartum depression: A population-based study: S ilverman et al.
Open accessAbstract
BACKGROUND: Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Only a few large population-based studies of PPD have used clinical diagnoses of depression and no study has examined how a maternal depression history interacts with known risk factors. The objective of this study was to examine the impact of a depression history on PPD and pre- and perinatal risk factors. METHODS: A nationwide prospective cohort study of all women with live singleton births in Sweden from 1997 through 2008 was conducted. Relative risk (RR) of clinical depression within the first year postpartum and two-sided 95% confidence intervals were estimated. RESULTS: The RR of PPD in women with a history of depression was estimated at 21.03 (confidence interval: 19.72-22.42), compared to those without. Among all women, PPD risk increased with advanced age (1.25 (1.13-1.37)) and gestational diabetes (1.70 (1.36-2.13)). Among women with a history of depression, pregestational diabetes (1.49 (1.01-2.21)) and mild preterm delivery also increased risk (1.20 (1.06-1.36)). Among women with no depression history, young age (2.14 (1.79-2.57)), undergoing instrument-assisted (1.23 (1.09-1.38)) or cesarean (1.64(1.07-2.50)) delivery, and moderate preterm delivery increased risk (1.36 (1.05-1.75)). Rates of PPD decreased considerably after the first postpartum month (RR = 0.27). CONCLUSION: In the largest population-based study to date, the risk of PPD was more than 20 times higher for women with a depression history, compared to women without. Gestational diabetes was independently associated with a modestly increased PPD risk. Maternal depression history also had a modifying effect on pre- and perinatal PPD risk factors.
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In a Swedish cohort of 707,701 mothers, mothers with a history of depression had about 20 times the odds of being diagnosed with postpartum depression in the year after birth compared with mothers without such history.
“They observed that when the mother had history with depression, her odds were twenty-fold that of a mother without such history of being diag nosed with post-partum depression (PPD) in the year that followed the birth.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Silverman et al., 2017
The Results report 707,701 women and postpartum depression diagnoses within the first year after delivery. They also report a roughly 21-fold relative risk for women with a depression history, but the paper reports relative risk, not odds; that measure in the claim is not supported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPrevious history of mental illness is an important factor for postpartum depression in mothers.
“However, previous history with mental illness is also important.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Silverman et al., 2017
The Results section ('Maternal depression history and risk for PPD'; page unavailable) reports a substantially increased postpartum-depression risk in women with a prior history of depression. The cited study examined depression history specifically, so it does not establish the broader claim about a history of mental illness generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredModerate preterm delivery is associated with a 1.36 times higher risk of postpartum depression.
“Moderate preterm delivery also had an effect, although more moderate with a 1.36 times higher risk of PPD.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Silverman et al., 2017
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References 42 · Cited by 425
- Authors
- Silverman, M. E., Reichenberg, A., Savitz, D. A., Cnattingius, S., Lichtenstein, P., Hultman, C. M., Larsson, H., & Sandin, S.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Brown University (US)
- Karolinska Institutet (SE)
- Örebro University (SE)
- Corresponding author
- Silverman, Michael E.
- ORCID
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2017-01-18
- Volume
- 34
- Issue
- 2
- Pages
- 178-187
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC5462547
- OpenAlex
- W2579565083
- Cited by
- 425
- References
- 42
- Citations by year
- 2026: 41 · 2025: 45 · 2024: 56 · 2023: 56 · 2022: 62 · 2021: 56 · 2020: 39 · 2019: 36 · 2018: 29 · 2017: 5
- FWCI
- 27.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Child Health and Human Development (R21HD073010)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- postpartum depression, maternal depression history, risk factors, gestational diabetes mellitus, pregestational diabetes, preterm birth, cesarean section, maternal age, perinatal risk factors
- MeSH terms
- Adolescent, Adult, Age Factors, Depressive Disorder, Female, Humans, Pregnancy, Prospective Studies, Registries, Risk Factors, Sweden, Cohort Studies, Diabetes, Gestational, Depression, Postpartum, Young Adult
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