Time trends in incidence of postpartum depression and depression in women of reproductive age

Sofie Egsgaard; Mette Bliddal; Lotte Rasmussen; Merete Lund Mægbæk; Xiaoqin Liu; Trine Munk-Olsen

doi:10.1016/j.jad.2024.08.167

Time trends in incidence of postpartum depression and depression in women of reproductive age

Sofie Egsgaard^*, Mette Bliddal, Lotte Rasmussen, Merete Lund Mægbæk, Xiaoqin Liu, Trine Munk-Olsen

^*Corresponding author for this work

National Centre for Register-based Research

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: Little is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general.

METHODS: Using Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline.

RESULTS: The study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8-35.9) for PPD and 18.9 (95% CI: 18.3-19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7-138.8) for PPD and 209.8 (95% CI: 208.1-211.5) for depression, and both groups had fluctuating time trends.

LIMITATIONS: Depression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence.

CONCLUSIONS: Incidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends.

Original language	English
Journal	Journal of Affective Disorders
Volume	366
Pages (from-to)	91-97
Number of pages	7
ISSN	0165-0327
DOIs	https://doi.org/10.1016/j.jad.2024.08.167
Publication status	Published - Dec 2024

Keywords

Depression
Postpartum depression
Reproduction
Time trends
Women

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10.1016/j.jad.2024.08.167Licence: CC BY

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title = "Time trends in incidence of postpartum depression and depression in women of reproductive age",

abstract = "BACKGROUND: Little is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general.METHODS: Using Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline.RESULTS: The study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8-35.9) for PPD and 18.9 (95% CI: 18.3-19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7-138.8) for PPD and 209.8 (95% CI: 208.1-211.5) for depression, and both groups had fluctuating time trends.LIMITATIONS: Depression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence.CONCLUSIONS: Incidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends.",

keywords = "Depression, Postpartum depression, Reproduction, Time trends, Women",

author = "Sofie Egsgaard and Mette Bliddal and Lotte Rasmussen and M{\ae}gb{\ae}k, {Merete Lund} and Xiaoqin Liu and Trine Munk-Olsen",

note = "Publisher Copyright: {\textcopyright} 2024",

year = "2024",

month = dec,

doi = "10.1016/j.jad.2024.08.167",

language = "English",

volume = "366",

pages = "91--97",

journal = "Journal of Affective Disorders",

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T1 - Time trends in incidence of postpartum depression and depression in women of reproductive age

AU - Egsgaard, Sofie

AU - Bliddal, Mette

AU - Rasmussen, Lotte

AU - Mægbæk, Merete Lund

AU - Liu, Xiaoqin

AU - Munk-Olsen, Trine

PY - 2024/12

Y1 - 2024/12

N2 - BACKGROUND: Little is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general.METHODS: Using Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline.RESULTS: The study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8-35.9) for PPD and 18.9 (95% CI: 18.3-19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7-138.8) for PPD and 209.8 (95% CI: 208.1-211.5) for depression, and both groups had fluctuating time trends.LIMITATIONS: Depression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence.CONCLUSIONS: Incidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends.

AB - BACKGROUND: Little is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general.METHODS: Using Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline.RESULTS: The study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8-35.9) for PPD and 18.9 (95% CI: 18.3-19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7-138.8) for PPD and 209.8 (95% CI: 208.1-211.5) for depression, and both groups had fluctuating time trends.LIMITATIONS: Depression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence.CONCLUSIONS: Incidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends.

KW - Depression

KW - Postpartum depression

KW - Reproduction

KW - Time trends

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=85202524289&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2024.08.167

DO - 10.1016/j.jad.2024.08.167

M3 - Journal article

C2 - 39187186

SN - 0165-0327

VL - 366

SP - 91

EP - 97

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Time trends in incidence of postpartum depression and depression in women of reproductive age

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