title: Prospective Longitudinal Study of Predictors of Postpartum-Onset Depression in Women With a History of Major Depressive Disorder.
abstract: OBJECTIVE
  Risk factors for postpartum depression in euthymic pregnant women with histories of major depressive disorder (MDD) were evaluated.
  
  
  METHODS
  From April 2003 to March 2009, 343 pregnant women with a history of Structured Clinical Interview for DSM-IV (SCID)-diagnosed major depressive disorder were prospectively assessed from the third trimester into the postpartum period using the SCID mood module and 17-item Hamilton Depression Rating Scale (HDRS). Data from 300 subjects who completed at least 2 mood module assessments (1 within 60 days before and the other within 60 days after delivery) were analyzed for predictive associations between variables assessed in the third trimester and the development of a postpartum depression.
  
  
  RESULTS
  The majority of women were euthymic in pregnancy by SCID criteria. Women with third trimester SCID-diagnosed depression (n = 45) versus euthymia (n = 255) had a significantly higher risk for having depression after delivery (24% vs 11%, P = .013). For pregnant euthymic women, third trimester total HDRS scores significantly predicted postpartum depression (P < .0001); specifically, scores on 3 HDRS items alone-work activities, early insomnia, and suicidality-significantly predicted postpartum depression. Antidepressant use in the third trimester in euthymic women did not confer protection against the onset of postpartum depression.
  
  
  CONCLUSIONS
  Among women with a history of MDD who are euthymic in the third trimester, 3 HDRS items-work activities, early insomnia, and suicidality-may be useful as screening items for clinicians working with pregnant women with histories of MDD to identify a group at risk for developing postpartum depression. Additionally, in euthymic women with a history of MDD, antidepressant use in the third trimester may not reduce the risk of developing postpartum depression.
authors.affiliation: 760 Westwood Plaza, Ste 28-251, Los Angeles, CA 90095-7057. rsuri03@gmail.com.|Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, California, USA.|Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Suri
authors.affiliation: Departments of Psychiatry, Pediatrics, and Obstetrics & Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Zachary N
authors.initials: ZN
authors.lastname: Stowe
authors.affiliation: Perinatal and Reproductive Psychiatry Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Lee S
authors.initials: LS
authors.lastname: Cohen
authors.affiliation: Departments of Psychiatry & Behavioral Sciences and Obstetrics & Gynecology, University of Miami Miller School of Medicine, Florida, USA.
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Newport
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, California, USA.|Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.
authors.forename: Vivien K
authors.initials: VK
authors.lastname: Burt
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, California, USA.|Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.
authors.forename: Ana R
authors.initials: AR
authors.lastname: Aquino-Elias
authors.affiliation: Departments of Psychiatry, Pediatrics, and Obstetrics & Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Bettina T
authors.initials: BT
authors.lastname: Knight
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center, San Antonio, Texas, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Mintz
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, California, USA.|Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.
authors.forename: Lori L
authors.initials: LL
authors.lastname: Altshuler
mesh_terms: D000328:Adult; D000339:Affect; D000928:Antidepressive Agents / Q000627:therapeutic use; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008487:Medical History Taking; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third / Q000523:psychology*; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology; D059020:Suicidal Ideation; D014481:United States / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents