Kristina M. Deligiannidis, MD, associate professor at The Feinstein Institute for Medical Research, along with her colleagues at Cummings School of Veterinary Medicine at Tufts University and the University of Massachusetts Medical School found that a common medication administered during or after labor, synthetic oxytocin, is associated with the development of postpartum depression or anxiety. These findings, which are published today in Depression and Anxiety, could help identify women at risk for postpartum depression and anxiety, a condition that affects one-in-eight women in the United States annually.
Postpartum depression is a severe, long-lasting form of depression that starts anywhere from a few days to six months after giving birth. Women with postpartum depression can experience a variety of symptoms, including depressed mood or severe mood swings, difficulty bonding with their child, withdrawal from family and friends, thoughts of suicide and fear of not being a good mother. These symptoms experienced by the mother can also have an impact on her child as well, affecting the child’s temperament, cognitive and social development.
Dr. Deligiannidis’ research is focused on understanding how the normal changes in hormones during pregnancy and postpartum may trigger postpartum depression in some women. Dr. Deligiannidis and colleagues may have found another risk factor – synthetic oxytocin, a hormone therapy given to women to induce labor and/or treat postpartum hemorrhage.
“Although oxytocin is a hormone naturally found in the body during childbirth, our study found, contrary to what we expected, that exposure to synthetic oxytocin – a common treatment administered during or after labor – was associated with an increase in risk for the development of postpartum depression and anxiety,” said Dr. Deligiannidis, who is also director of Women’s Behavioral Health at Northwell Health’s Zucker Hillside Hospital. “Since synthetic oxytocin is such an important and commonly used medicine for peripartum women, further research should examine dose, duration, timing and reason for treatment so that we can better identify which women may be at risk for developing postpartum depression and anxiety. Better identification of factors that place women at risk could significantly decrease the number of women who suffer with postpartum depression.”
Through collaboration with researchers from Cummings School of Veterinary Medicine at Tufts University and the University of Massachusetts Medical School, Dr. Deligiannidis and her team reviewed data from the Massachusetts Integrated Clinical Academic Research Database of approximately 47,000 births by woman between the ages of 15 and 50. They found that women with a history of depressive or anxiety disorder pre-pregnancy who were given synthetic oxytocin during or after labor experienced a 36 percent increase in risk of postpartum depression or anxiety disorder. For deliveries by women with no history of pre-pregnancy depressive or anxiety disorder, the use of synthetic oxytocin was associated with a 32 percent increase in risk of postpartum depressive or anxiety disorder compared with women not receiving the medication.
“Our collaboration underscores the value of de-identified clinical data repositories in clinical research,” said Aimee Kroll-Desrosiers, MS, from the Department of Quantitative Health Sciences at the University of Massachusetts Medical School.
“Despite the negative impacts to the mother and child, relatively little research has been done to examine the physical mechanisms that lead to postpartum depression,” said Benjamin C. Nephew, PhD, assistant professor in the Department of Biomedical Sciences Neuroscience and Reproductive Biology Section at Cummings School of Veterinary Medicine at Tufts University. “While there may be physiological factors that have a role in the condition, these findings indicate that we need to examine the treatments administered during and post labor as these could also contribute to the risk of suffering from postpartum depression and/or serve as novel predictive factors.”
“A birth of a child should be a time of great joy, but for women suffering from postpartum depression, it can be a time of great struggle,” said Dr. Kevin J. Tracey, MD, president and CEO of the Feinstein Institute. “With the work of Dr. Deligiannidis and her team, we hope to better understand postpartum depression and postpartum psychosis so that we can help prevent the onset of these conditions or treat them when faced.”
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