The Impact of Treating Major Depression During Pregnancy on the Postpartum Phase

Major depression during pregnancy is a risk factor for postpartum depression (PPD). Medically acceptable treatments for depression during pregnancy and postpartum are limited and many women are turning to complementary and alternative treatments. The current project examined whether treatment of major depression during pregnancy reduced the risk for PPD and explored predictors of PPD in this high-risk sample. One hundred twenty women were clinically assessed using the Hamilton Rating Scale for Depression (HRSD17), the Beck Depression Inventory (BDI-II), and the Structured Clinical Interview for DSM-IV (SCID) at ten weeks, six months, and nine months postpartum following random assignment to one of three treatments delivered over eight weeks during pregnancy: active acupuncture, control acupuncture, and control prenatal massage. Mixed effects analyses revealed that responders to the acute phase of treatment during pregnancy had significantly lower postpartum BDI-II scores compared to non-responders. Results also revealed a significant treatment assignment by time interaction on postpartum HRSD17 scores such that the active acupuncture group maintained improvement while the control groups worsened postpartum. Exploratory ROC analyses revealed the following predictors of PPD: discontinuing antidepressant medication, high intake HRSD17 scores, high late pregnancy HRSD17 scores, low expectations of treatment, and a history of childhood emotional abuse. Results suggest that successful treatment of depression during pregnancy may lower the risk of developing PPD