番茄社区

NEW YORK -- Familial history of psychiatric disorders was associated with increased risk for postpartum psychiatric episodes in first-time moms, researchers reported here from a large Danish registry study.

Within 6 months of giving birth, first-time mothers had higher risk for developing a psychiatric disorder if they had siblings or parents with a psychiatric disorder, compared with mothers without that family history (HR 1.45, 95% CI 1.28-1.65), according to Anna Bauer, PhD, of University of North Carolina at Chapel Hill, and colleagues.

This increased risk was seen across several psychiatric conditions reported among first-degree family members:

• Bipolar disorder: HR 2.86 (95% CI 1.88-4.35)
• Schizophrenia: HR 1.58 (95% CI 1.27-1.95)
• Unipolar disorder: HR 1.52 (95% CI 1.24-1.87)
• Other mood disorder: HR 1.78 (95% CI 1.03-3.06)

The findings were presented at the and simultaneously published online in the .

"We know that family psychiatric history is an important risk factor for lifetime psychiatric illness, so we were not surprised to see similar associations in the postpartum period," Bauer explained to 番茄社区, adding that "postpartum psychiatric disorders are one of the most common complications of pregnancy and can affect the mother, child, and the entire family."

"Although there's been recent recognition of the importance of screening for perinatal mood and anxiety disorders, it is still very difficult to predict who will develop a postpartum psychiatric disorder. We wanted to more thoroughly examine family history, because this information can be used to help identify women who may be at risk for a postpartum psychiatric disorder before their symptoms emerge," she explained.

The analysis included 362,462 first-time mothers born in Denmark. Information on births and psychiatric diagnoses were collected from the Danish birth registry and the Psychiatric Central Register. During a psychiatric disorder during the postpartum period was defined as experiencing a psychiatric episode. This did not include substance abuse, organic mental disorders or mental retardation.

This familial risk extended beyond just first-degree relatives, with a slightly increased risk for postpartum disorders seen among mothers whose second-degree (HR 1.16, 95% CI 1.02-1.31) and third-degree relatives (HR 1.27, 95% CI 1.03-1.58) reported a psychiatric history.

However, there were no differences in familial risk in regards to sex, with a similarly increased risk seen for moms whose mothers (HR 1.50, 95% CI 1.27-1.77) or fathers (HR 1.54, 95% CI 1.27-1.87) experienced a psychiatric disorder.

"Psychiatric disorders in postpartum women have additional childbirth-related biological components, so we were interested to see that familial risk was transmitted equally by female and male relatives," Bauer explained, adding how her group was also "intrigued" to find that mothers without any personal history of psychiatric illness also experienced an increased risk simply due to family history.

"This may provide added evidence to findings from twin and sibling studies that postpartum mood disorders are more heritable than lifetime mood disorders, and provides support that family history could be an especially important risk factor for assessing new-onset psychiatric disorders in the postpartum period," she added.

In addition to familial risk, a personal history of psychiatric disorders among first-time mothers was a strong predictor of experiencing a psychiatric disorder in the postpartum period after adjustment for family risk (HR 8.66, 95% CI 7.97-9.40).

According to current clinical practice guidelines, screening of perinatal psychiatric disorders is not included, Bauer highlighted.

"Family psychiatric history is a relatively simple measure that could be included to assess women who are at greater risk of developing a postpartum mental illness. When asking about family history, clinicians should pay particular attention if a family member has had bipolar disorder, and be sure to ask about psychiatric disorders in both female and male relatives," she recommended for clinicians.

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