University of Pittsburgh researchers find depression affects about 1 in 7 new mothers

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In what is believed to be the largest study of its kind on depression in new mothers, researchers at the University of Pittsburgh found that about 1 in 7 women have experienced the illness before, during or after pregnancy.

The study, published Wednesday online in the Journal of the American Medical Association, involved screening 10,000 new mothers at Magee-Womens Hospital of UPMC over four years ending in 2011.

Nearly 1,400 of those women screened for depression. The largest portion, 40 percent, of the depressive group said they experienced it postpartum, 33.4 percent during pregnancy and 26.5 percent before pregnancy. Further interviews found that about 22 percent of them had bipolar disorders, and roughly 20 percent of the 1,400 had suicidal thoughts.

The demographics of these 1,400 women, as well as other findings in the study, confirmed what prior studies have found: New mothers were more likely to test positive for depression if they were younger, single, publicly insured, less well educated and African-American, but that the percentages for all demographics are larger than was known just a few decades ago.

Because of the size of the study, the hope is that it will effect change not only in new parents and doctors, but perhaps politicians to make screening for depression in new or expectant mothers the norm in health care, said Dorothy Sit, assistant professor of psychiatry at Pitt and an investigator on the study.

Cursory screenings for depression using free questionnaire tools found online "could even be done in the home," said Dr. Sit, who is also a researcher at Western Psychiatric Institute and Clinic of UPMC. "But ideally, it would be done in a clinical setting so someone can monitor results, and have them reviewed by a clinician."

Some OB-GYN and primary care physicians already make such screenings part of annual exams, she said, but it is not mandated in most states, including in Pennsylvania.

"This can save lives," Dr. Sit said, if screening new or expectant mothers is done regularly and if there is follow-up care given to those who test positive.

Dr. Sit said one of the great outcomes of the study, which was funded by a National Institute of Mental Health grant, is that the Pitt researchers had the resources to offer follow-up services for all those new mothers who tested positive for depression -- including immediate assistance to the nearly 20 percent of them who said they'd had suicidal thoughts.

It's hard to tell from the available data about how many of these women might have attempted or been successful at an attempt at suicide, but, "We could have been saving lives," she said.

One of the anecdotal findings of the study, she said, was that during the screenings and follow-up interviews, it became clear to the team of researchers that one basic benefit of the study was that many of the 10,000 women in the study were getting new information about the risks of depression in new mothers.

"Many were not aware of this," she said. "People are sort of riding [the depression] out. They misinterpret this as a normal part of the postpartum experience, when depression left untreated can take nine to 12 months to recover on its own."

June Horowitz, a postpartum depression researcher and professor of nursing at Boston College, said the Pitt study is "an important finding" and she hopes it helps add to the nation's understanding of mental illness in new mothers.

"If women were hemorrhaging postpartum in these numbers, it would be a national issue," said Ms. Horowitz, who worked on a similar study involving 5,000 women in Boston. "But because it's mental health, it's not."

"I think we still in this country really do not recognize mental health issues, we still have that Puritan, pull-yourself-up-by-your-bootstraps, be-tough attitude," she said.

She said many smart physicians already are on the lookout for depression in new and expectant mothers, but "we just have to get all the insurance companies to pay for [formal screenings] now."

And in the United States, she said, "we still do not have a home [postpartum] visiting program like they do in England. Instead, after the birth, we just drop them at home with no resources if something happens.

"It should be the gold standard that everyone gets screened for postpartum depression."

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Sean D. Hamill: or 412-263-2579.


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