title: Antenatal and postnatal risk factors of postpartum depression symptoms in Thai women: A case-control study.
abstract: OBJECTIVE
  To examine the effects of different predictors on the incidence and severity of postpartum depression (PPD) symptoms in a Thai population.
  
  
  METHODS
  In this case control study we delineate the clinical, demographic and socio-economic risk factors associated with PPD symptoms. We used the Edinburgh Postnatal Depression Scale (EPDS) 4-6 weeks postpartum to divide parturients into those with (n = 53) and without (n = 260) PPD using a cutoff score of 11.
  
  
  RESULTS
  This study confirms previous risk factors for PPD (i.e. a history of lifetime major depression and PPD, a history of depression during pregnancy, multi-parity, unwanted pregnancy, childcare stress, premenstrual syndrome, pain symptoms in the early puerperium), and describes new risk factors (i.e. use of caffeine during pregnancy and baby feeding problems). There are significant associations between (a) a lifetime history of major depression and depression during pregnancy, a history of postpartum depression and lifetime mania; and (b) a history of lifetime mania and a history of depression during pregnancy and a history of postpartum depression.
  
  
  CONCLUSIONS
  A history of lifetime major depression and depression during pregnancy are the most important risk factors for postnatal depression, suggesting that sensitization processes increase risk towards postpartum depression. Postpartum depression may be a subtype of unipolar depression or bipolar disorder.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Chutima
authors.initials: C
authors.lastname: Roomruangwong
authors.affiliation: Srinakharinwirot University, Bangkok, Thailand.
authors.forename: Sinaporn
authors.initials: S
authors.lastname: Withayavanitchai
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Deakin University, Geelong, Australia. Electronic address: dr.michaelmaes@hotmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Maes
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D019052:Depression, Postpartum / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D011181:Postnatal Care / Q000379:methods; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013785:Thailand; D055815:Young Adult
keywords: Bipolar disorder; Depression; Inflammation; Postnatal; Postpartum depression