While a consensus on an exact definition of the postpartum period is lacking, many consider it to be the first 12 months after birth. Around 50% of patients will experience onset of symptoms before or during pregnancy. Of those who develop symptoms following delivery, onset typically occurs within the first months following parturition. With or without treatment, postpartum depression may resolve or may develop into a chronic depressive disorder. Patients remain at high risk of recurrence of depressive episodes.
Postpartum depression affects maternal-infant bonding and is associated with abnormal development and cognitive impairment in the children. The condition also may have negative effects on the mother's relationship with her partner and other children.
The strongest risk factor for postpartum depression is a personal history of depression (either perinatal or nonperinatal). Other risk factors include stressful life events, such as emigration or relationship conflict, and poor social and/or financial support during the perinatal period. Comorbid mental illness is common. Many other potential risk factors have been identified, such as young age, single marital status, and unintended pregnancy, although these are less well established.
F53.0 – Postpartum depression
58703003 – Postpartum depression
Differential Diagnosis & Pitfalls
- Normal postpartum changes in sleep, energy level, and appetite
- Postpartum blues – symptoms are mild and self-limited, typically resolving within 2 weeks of onset
- Bipolar disorder – patients have a past history of mania and/or hypomania, and agitation is more prevalent than in unipolar depression
- Postpartum psychosis – marked by psychotic symptoms such as hallucinations
- Generalized anxiety disorder
- Major depressive disorder
- Dysphoric mood disorder (see, eg, premenstrual dysphoric disorder)