Researchers Confirm Positive Outcomes With SSRI Treatment for Postnatal Depression

New study findings from Jama Network examined postnatal selective serotonin reuptake inhibitor (SSRI) treatment to maintain postnatal depression after childbirth, finding that it was effective.

Many women face the common psychiatric disorder known as postnatal depression during the year following childbirth. According to the study, 10% to 15% of women are affected with postnatal depression. Differing from postpartum depression, which occurs immediately following childbirth, postnatal depression is reoccurring depressive episodes that lead to a higher display of depression in the years after childbirth. The depressive episodes not only affect the mother, but the child, and could lead to long-term partner relationship issues.

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According to the study authors, SSRIs are the preferred treatment for postnatal depression compared to other antidepressants. SSRIs are reported to have better safety outcomes and more positive effects, although the long-term effect of use for women and their children is unknown.

“This gap in knowledge potentially contributes to a lack of confidence in medicalizing postnatal depression among clinicians and the affected women. Data from primary care records in the UK have indicated that the prevalence of postnatal depression is 11%, whereas the initiation rate of SSRIs within 6 months postpartum for postnatal depression is around 3%,suggesting a gap between diagnosis and medication use. Suboptimal treatment is harmful because poorly controlled postnatal depression has been associated with many negative outcomes in mothers and offspring,” said the press release authors.

The study used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), which was a prospective population-based cohort study centered in Norway. The women involved in the study began enrollment at 17 to 18 weeks’ gestation from 1999 to 2008. The press release noted that within the current study, researchers used data on women who experienced depression symptoms at week 30 and postpartum month 6. Prenatal factors were accounted for during analysis.

The researchers categorized the 61,081 mother-child dyads as SSRI-treated postnatal depression if SSRIs were used; non-SSRI treated postnatal depression if the mother did not use the treatment; and non-postnatal depression for women who did not experience symptoms.

The study used a postnatal depression diagnosis from the 6-item form of the Edinburgh Postnatal Depression Scale as a score of 7 or greater at 6 months postpartum.

“We selected several prenatal factors measured in MoBa as potentially associated with postnatal depression diagnosis and postnatal SSRI treatment. We then ran univariable and multiple logistic regressions to establish how these factors performed in the sample and use in the propensity score model. The resultant propensity score was used as an adjusting variable for postnatal SSRI exposure probability in the outcome analysis. The propensity score adjustment approach was intended to emulate randomized assignment of postnatal SSRI treatment to prevent bias from imbalanced prenatal factors between treated and untreated women when studying treatment effectiveness,” said the press release authors.

After analyzing maternal and child outcome behaviors, the researchers were able to identify that postnatal SSRI treatment resulted in a reduced risk of maternal depression and child expression behaviors. ADHD in children was connected to postnatal depression, but the researchers did not find that SSRI use increased the risk for children to have more advanced psychopathology or motor and language delays.

According to the press release, the results found that out of the 61,081 mother-child dyads, 8671 met the scale for a postnatal depression diagnosis and 177 were treated with an SSRI. The treatment was able to reduce risk of postnatal depression that related to maternal mental health, relationship satisfaction, and externalizing behaviors within the child’s early years.

Reference:

Long-Term Maternal and Child Outcomes Following Postnatal SSRI Treatment. Jama Network. News release. August 29, 2023. Accessed August 31, 2023. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808867.