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Management of postnatal depression

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Postnatal depression may affect up to 10 per cent of women and may adversely affect the maternal-infant relationship.1 Postnatal depression may occur as a recurrence of pre-existing depression or may be a manifestation of a psychotic disorder or may occur de novo.

Most cases develop in the first three months after giving birth.2 Postnatal depression may, in turn, impact on other family members and the child's long-term cognitive and emotional development because women with postnatal depression are more likely to show more negative behaviour towards their child.3

Risk factors

Postnatal depression may be associated with a previous psychiatric disorder, lack of supportive relationships or recent life events, such as bereavement, unemployment and unplanned pregnancy. Other risk factors for developing postnatal depression include pre-eclampsia, hospitalisation during pregnancy, emergency caesarean section and admission of the baby to special care.2

NICE recommends health professionals ask about past or present severe mental illness at first contact with the patient during the antenatal and postnatal periods.4 An assessment of previous psychiatric treatment, including inpatient care and a family history of perinatal mental illness, should also be made.

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