Prediction, detection, and treatment of postnatal depression

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Abstract
There is scant evidence for a biological basis to postpartum depression.1 Although the presence of the ‘maternity blues’ has been found in a number of studies to be related to the subsequent development of postpartum depression, and this association is consistent with hormonal aetiological factors, the basis of the association remains obscure.1 Gynaecological and obstetric factors have been implicated as risk factors in some reports but not in others. Two studies have found an interesting interaction that suggests that obstetric factors may be important in a vulnerable subgroup of women. Murray and Cartwright found that it was only among those with a previous history of depressive disorder that delivery complications were associated with postnatal depression9; and O’Hara and colleagues found that the joint presence of depression during pregnancy and higher levels of obstetric stressors was a significant risk factor for postpartum depression.10