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Study reveals impact of postpartum psychiatric disorders

Monday March 30th, 2020

Women who suffer from psychiatric disorders after the birth of their first child are less likely to have further children, a Danish study reports today (30 March 2020).

The research, the first to investigate the issue in a large nationwide population, found that 69% of women who experienced postpartum psychiatric disorders within the first six months after the birth of their first baby went on to have further children compared with 82% of mothers who did not experience psychiatric problems.

Dr Xiaoqin Liu, post-doctoral researcher at the National Centre for Register-based Research at Aarhus University, and her team analysed data from Danish registries for 414,571 women who had their first live birth between 1997 and 2015 in Denmark.

They followed the women for a maximum of 19.5 years until the next live birth, emigration, death, their 45th birthday or June 2016, whichever occurred first, and identified 4,327 (1%) who experienced psychiatric disorders following the birth of their first child.

Writing in the latest edition of Human Reproduction, the research team say that while the 1% were a third less likely to have a second live birth compared to women who did not experience psychiatric disorders, if the first child died, the difference in subsequent live birth rates disappeared.

However, if the women required hospital treatment for their psychiatric problem, the likelihood of them having a second child nearly halved. This was the case whether or not the first child survived.

Dr Liu said: “Although fewer women with postpartum psychiatric disorders had subsequent children, it is noteworthy that about 69% of these women still chose to have a second child.

“For the remaining 31% of women, we need to differentiate the reasons why they did not have another child. If they avoided another pregnancy due to fear of relapse, an important clinical message to them is that prevention of relapse is possible.”

The researchers say that other possible explanations for the reduction in the subsequent live birth rate may be that women with postpartum psychiatric disorders are less able to conceive or have more problematic relationships with partners.

“The reason why women with postpartum psychiatric disorders choose to have fewer children needs to be explored further,” said Dr Liu.

She said the findings means that women who want to have another child should seek medical help, so that treatment plans can be put in place to mitigate the risk of relapse.

Previous research has shown that about 3% of women develop psychiatric disorders in the first three months after childbirth. These disorders encompass a wide range of mental health problems and usually involve a combination of abnormal thoughts, behaviours and relationships with other people.

Liu X, Plana-Ripoll O, Ingstrup KG et al. Postpartum psychiatric disorders and subsequent live birth: a population-based cohort study in Denmark. Human Reproduction. March 2020. doi:10.1093/humrep/deaa016

Tags: Childbirth and Pregnancy | Europe | Mental Health | Women's Health & Gynaecology

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