WOMEN AT RISK FOR POSTPARTUM-ONSET MAJOR DEPRESSION

There is considerable evidence that the childbearing years represent a time when women are highly vulnerable to developing mood disorders. P rospective, cross-sectional, and retrospective studies have demonstrat ed that more than 10% of new adult mothers will experience a major dep ressive episode during the first postpartum year. Changes in the healt h care delivery system will result in increased pressure on the obstet rician/gynecologist to identify and treat women with postpartum-onset depression. Despite shortcomings in the available literature, prospect ive studies have identified risk factors for developing postpartum dep ression. Furthermore, the clear overlap between the normal sequelae of childbirth and the symptoms of major depression, including alteration s in sleep, energy, libido, appetite, and body weight, underscores the need to develop guidelines for early identification. We furnish a bri ef overview of postpartum mood disorders with a primary focus on the a ntenatal and postnatal risk factors for developing postpartum depressi on. Based on the extant literature and our clinical experience, a set of recommendations for early identification and treatment is provided.