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PLoS One. 2016 Jan 25;11(1):e0144274. doi: 10.1371/journal.pone.0144274. eCollection 2016.

Delineating the Association between Heavy Postpartum Haemorrhage and Postpartum Depression.

Author information

1
Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
2
Department of Biostatistics, Harokopio University, Athens, Greece.
3
Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
4
FinnBrain Birth Cohort Study, Turku Brain and Mind Centre, Institute of Clinical Medicine, University of Turku, Turku, Finland.

Abstract

OBJECTIVES:

To explore the association between postpartum haemorrhage (PPH) and postpartum depression (PPD), taking into account the role of postpartum anaemia, delivery experience and psychiatric history.

METHODS:

A nested cohort study (n = 446), based on two population-based cohorts in Uppsala, Sweden. Exposed individuals were defined as having a bleeding of ≥1000 ml (n = 196) at delivery, and non-exposed individuals as having bleeding of <650 ml (n = 250). Logistic regression models with PPD symptoms (Edinburgh Postnatal Depression scale (EPDS) score ≥ 12) as the outcome variable and PPH, anaemia, experience of delivery, mood during pregnancy and other confounders as exposure variables were undertaken. Path analysis using Structural Equation Modeling was also conducted.

RESULTS:

There was no association between PPH and PPD symptoms. A positive association was shown between anaemia at discharge from the maternity ward and the development of PPD symptoms, even after controlling for plausible confounders (OR = 2.29, 95%CI = 1.15-4.58). Path analysis revealed significant roles for anaemia at discharge, negative self-reported delivery experience, depressed mood during pregnancy and postpartum stressors in increasing the risk for PPD.

CONCLUSION:

This study proposes important roles for postpartum anaemia, negative experience of delivery and mood during pregnancy in explaining the development of depressive symptoms after PPH.

PMID:
26807799
PMCID:
PMC4726585
DOI:
10.1371/journal.pone.0144274
[Indexed for MEDLINE]
Free PMC Article

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