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Risk of Postpartum Psychosis Increases with Age

Kathleen Blanchard's picture

Researchers find that half of women diagnosed with postpartum psychosis have no history of mental illness. The risk of postpartum psychosis is greater in women over age 35 who give birth for the first time.

Researchers are not certain what combination of events leads to mental illness in the postpartum period, especially in women with no previous history of psychiatric disorder. Scientists suggest that little is known about treatment options for women who experience the devastating condition that can lead to infanticide, hospitalization or self-harm.

Study investigator Christina M. Hultman, PhD, from Karolinksa Institutet, in Stockholm, Sweden says, "We know from our prior research that women with previous psychiatric histories are at considerably increased risk of developing postpartum psychosis. In this study, we wanted to find out if there were other risk factors, such as perinatal complications or sociodemographic factors, that might be more influential [in determining postnatal risk for psychosis] in women without a history of mental illness."

New onset of mental illness from postpartum psychosis affects women age 35 or older, following first childbirth. Researchers analyzed data from 745,596 first-time mothers who gave birth between 1983 and 2000. They found that women over age 35 were 2.4 times more likely to suffer a psychotic episode after childbirth, targeting age as one risk factor.

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They also discovered that women who deliver infants with higher birth weights, and women with diabetes seem to be protected from postpartum psychosis.

Unfortunately, the study was unable to identify other risk factors for postpartum psychosis that might lead to early intervention and treatment.

The authors concluded, "The immediate period following childbirth carries, compared to subsequent periods, high incidence rates for psychoses in first-time mothers, even among those without any previous psychiatric hospitalization."

The authors recommend that clinicians carefully screen for postpartum psychosis in women, especially in the first month following first time childbirth.

PLoS Med. Published online February 10, 2009.