Premenstrual syndrome and dysphoric disorder as risk factors for postpartum depression

Abstract

Objective: To investigate a possible association between postpartum depression and premenstrual symptoms.

Design: Population-based cohort.

Setting: University Hospital, Sweden.

Population: During one year, May 2006 to June 2007, all delivering women in the hospital were asked to participate.

Methods: The participating women answered three questionnaires, at five days, six weeks and six months postpartum, containing the Edinburgh Postnatal Depression Scale (EPDS) and questions assessing previous premenstrual symptoms, medical history and life style.

Main outcome measures: The woman's self-reported depressive case/control status, women with 12 or more points on the EPDS being considered as cases.

Results: Among the 2318 participating women, 7.1% had a history of premenstrual syndrome and 2.9% a history of premenstrual dysphoric disorder. Previous premenstrual syndrome/premenstrual dysphoric disorder was associated with self-reported postpartum depression at five days, six weeks and six months postpartum. After stratification for parity, the associations remained significant solely among multiparas.

Conclusions: There appears to be an association between a history of premenstrual symptoms and development of self-reported postpartum depression. Parity was identified as effect modifier. This finding is clinically important for health care professionals working in maternity care.