Research paperPreconception gynecological risk factors of postpartum depression among Japanese women: The Japan Environment and Children's Study (JECS)

- Preconception endometriosis, and menstrual problems are risk factors of postpartum.
- This is the first study, in Japanese women, to show this association.
- The association was constant after adjustment for a wide variety of known risk factors.
- To assess those morbidities would be valuable for prediction and intervention on PPD.

BackgroundPostpartum depression is one of the major causes of disability among women who are on their childbearing years. Identifying people at risk of postpartum depression may improve its management. The objective of this study was to determine the probable association between postpartum depression and some preconception gynecological morbidities.MethodsData from a nationwide birth cohort study, the Japan Environment and Children's study (JECS), up to one month of postpartum were analyzed. To assess postpartum depression, the Edinburgh Postnatal Depression Scale (EPDS) was used; 11 preconception gynecological morbidities were considered as risk factors. Covariates included psychiatric illness history, psychosocial factors, some pregnancy adverse outcomes, birth outcomes, socio-demographic and health behavioral factors.ResultsExcept for the prevalence of previous miscarriage, leiomyoma and polycystic ovarian syndrome, depressive women had more gynecological morbidities compared to non-depressive ones.In logistic regression model, endometriosis (OR, 1.27; 95%CI: 1.15-1.41), dysmenorrhea (OR, 1.13; 95%CI: 1.06-1.21) and abnormal uterine bleeding (OR, 1.21; 95%CI: 1.15-1.29) were associated with postpartum depression.Limitations
- We could not specify in detail which type of gynecological morbidity was associated with postpartum depression, because the current design was not exclusively oriented by the JECS research question.
- A part of gynecological morbidities were self-reported.ConclusionWomen with endometriosis and menstrual problems were at risk of developing postpartum depression.This study suggests a perinatal mental health screening for predisposed women.