CONTACT: DAVE PEDERSEN
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Iowa City IA 52242
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UI researchers study postpartum anxiety, depression
IOWA CITY, Iowa -- Doctors know that depression after pregnancy is fairly
common, affecting as many as 10 to 15 percent of women who give birth.
Less attention, however, has been given to women who suffer anxiety after
giving birth, according to University of Iowa researchers who studied postpartum
anxiety among Iowa women.
In a study published in the July issue of the Journal of Nervous and
Mental Disease, Scott Stuart, M.D., UI assistant professor of psychiatry,
and colleagues from the UI and Iowa State University report that anxiety's
effects on the mother and child can be just as serious as depression, can
occur as late as months after giving birth and sometimes overlap with postpartum
"A fair number of women experience postpartum depression or anxiety
and shrug it off as part of being a parent, or ignore it for fear that
they may be criticized for not handling motherhood properly," Stuart
said. "Often the depression or anxiety comes after the first child
because the new mother doesn't have the previous experience with which
to compare it."
Stuart and his colleagues studied 107 women across Iowa who had recently
given birth, none of whom sought treatment for depression or anxiety. The
women were selected randomly from state birth records. The average age
of the women in the study was 31 years old. All were married, and 46.5
percent were having their first child.
The women completed psychological questionnaires that measure depression
and anxiety at 14 and 30 weeks after giving birth. The researchers found
the prevalence of anxiety among the mothers was 8.7 percent at 14 weeks
and 16.8 percent at 30 weeks postpartum. The prevalence of depression was
measured at 23.3 percent at 14 weeks and 18.7 percent at 30 weeks postpartum.
These prevalence rates are comparable to findings from previous studies,
the researchers noted.
A number of women in the study did not develop anxiety or depression
for as many as seven months after giving birth, Stuart said, but there
is no single explanation as to why women become depressed or anxious in
the weeks or months after delivery.
"It depends on how life circumstances change and how those affect
what's going on," he said. "For example, a woman may give birth
to her first child and things go smoothly for the first few weeks. However,
after her maternity leave is up and she prepares to go back to work, childcare
issues become more salient and the conflict between working and staying
home becomes greater. There are a lot of different factors that can trigger
anxiety or depression."
The researchers also found a strong correlation between anxiety symptoms
and concurrent depressive symptoms, meaning that some women may experience
both depression and anxiety during the postpartum period.
"My feeling is that postpartum depression and anxiety is underdiagnosed
and undertreated," Stuart said. "In part, this is due to the
fact that some women are not aware they should seek help for these conditions.
Additionally, some parents and doctors have concerns about the safety of
antidepressant medicine for mothers who are breastfeeding."
Stuart noted that recent studies, however, indicate that commonly prescribed
antidepressants are safe for mothers who are breastfeeding. "Once
the child is around 10 weeks old, it's relatively safe to use these medications,"
he said. "There have been some concerns with benzodiazapines, which
are drugs commonly used for anxiety. These medications are probably best
avoided during breastfeeding. Most of the proven antidepressants also work
well for treating anxiety, however. Overall, the potential problems are
far outweighed by the known effects of postpartum depression to the mother
Psychotherapy is another option. Stuart and his colleagues have completed
a study on interpersonal psychotherapy and postpartum depression. The results,
which the researchers will publish, are very promising, he noted.
Whatever the treatment, doctors should screen mothers for depression
or anxiety during routine postpartum check-ups, Stuart said. "Our
studies show that postpartum anxiety or depression is quite common. Mothers
need to know that safe, effective treatments are available."