Perinatal mood episodes are highly prevalent in women with bipolar disorder and recurrent major depression, UK research shows.
The team found that women with bipolar I disorder have a 50% risk for a major mood episode during the perinatal period.
Mood episodes typically occurred within the first postpartum month, with mania or psychosis having an earlier onset than depression.
Published in JAMA Psychiatry, the study suggests that physicians and other healthcare providers should discuss the risk for illness in relation to childbirth in women of childbearing age with a history of mood disorders.
"Pregnant women with a history of mood disorders should be monitored closely throughout pregnancy and especially in the postpartum period," state lead researcher Ian Jones (Cardiff University) and colleagues.
The study included 1785 women who gave birth to one or more children. Based on DSM-IV criteria, 980 women were diagnosed with bipolar I disorder, 232 with bipolar II disorder, and 573 with recurrent major depression.
Of the women with bipolar I disorder, the lifetime prevalence of a mood episode in the perinatal period was 69.5%.
Similarly, 69.0% of women with bipolar II disorder and 67.4% of women with recurrent major depression were affected by a mood episode during pregnancy or the postpartum period.
Women with bipolar I disorder were affected by a mood episode during the perinatal period in one of every two pregnancies. For women with bipolar II disorder or recurrent depression, 40% were affected by mood episode during pregnancy or the postpartum period.
Although women with bipolar I disorder had fewer pregnancies and deliveries than those with recurrent depression, they had the highest rates of perinatal mood episodes, note the researchers.
Approximately 80% of the perinatal mood episodes in women with bipolar I disorder and 72% of episodes in women with recurrent major depression occurred within the first 4 weeks following childbirth.
By contrast, just 53% of episodes in women with bipolar II disorder occurred within the first 4 weeks postpartum.
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