Fear of birth can increase risk of PPD

Women with a diagnosed fear of childbirth are at an increased risk of postpartum depression (PPD), according to a new study in BMJ Open.

Researchers from the University of Eastern Finland, Kuopio University Hospital, the Finnish National Institute for Health and Welfare, Copenhagen University Hospital, the Nordic School of Public Health, and Emory University used data from three Finnish health registers  for 2002-2010 and looked at all singleton births from that time (n= 511,422) to gauge the prevalence of PPD and the risk factors associated with it.

In total, 1439 of the 511,422 (0.3%) women experienced PPD. Women with a history of depression had a higher prevalence of PPD (1007 of 18,888, 5.3%) than women with no history of depression (431 of 511,422, 0.1%). In fact, after adjusting for variations, a history of depression was the strongest risk factor for PPD. Other strong risk factors for PPD include major congenital anomaly, nulliparity, cesarean birth, and fear of childbirth.

Among the 30% of women with PPD but no prior history of depression, PPD was associated with a fear of childbirth (adjusted odds rate [aOR] 2.71, 95% CI [confidence interval] 1.98 to 3.71); cesarean birth (aOR 1.38, 95% CI 1.08 to 1.77); preterm birth (aOR 1.65, 95% CI 1.08 to 2.56); and major congenital anomaly (aOR 1.67, 95% CI 1.15 to 2.42) when compared to women with no PPD and no history of depression.

Investigators concluded that a history of depression was the most important predisposing factor for PPD. Women with no history of depression were at an increased risk of PPD if certain adverse events occur during pregnancy. A physician-diagnosed fear of childbirth was the adverse event mostly likely to increase the risk of PPD in this population.

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