Antenatal and postnatal risk factors of postpartum depression symptoms in Thai women: A case-control study

•Lifetime depression and prenatal depression are the most important risk factors for developing postpartum depression (PPD).•Sensitization processes may play a role in increasing risk to develop PPD.•Risk factors for PPD include lifetime mania, caffeine use, post-delivery wound pain, and baby's sucking problems.

ObjectiveTo examine the effects of different predictors on the incidence and severity of postpartum depression (PPD) symptoms in a Thai population.MethodsIn this case control study we delineate the clinical, demographic and socio-economic risk factors associated with PPD symptoms. We used the Edinburgh Postnatal Depression Scale (EPDS) 4-6 weeks postpartum to divide parturients into those with (n = 53) and without (n = 260) PPD using a cutoff score of 11.ResultsThis study confirms previous risk factors for PPD (i.e. a history of lifetime major depression and PPD, a history of depression during pregnancy, multi-parity, unwanted pregnancy, childcare stress, premenstrual syndrome, pain symptoms in the early puerperium), and describes new risk factors (i.e. use of caffeine during pregnancy and baby feeding problems). There are significant associations between (a) a lifetime history of major depression and depression during pregnancy, a history of postpartum depression and lifetime mania; and (b) a history of lifetime mania and a history of depression during pregnancy and a history of postpartum depression.ConclusionsA history of lifetime major depression and depression during pregnancy are the most important risk factors for postnatal depression, suggesting that sensitization processes increase risk towards postpartum depression. Postpartum depression may be a subtype of unipolar depression or bipolar disorder.