[Pre-, peri- and postpartal depression].

INTRODUCTION: Postpartal affective disorders are with a prevalence between 8 % and 15 % highly frequent maternal diseases after childbirth. An undetected and untreated postpartum depression causes a wide range of negative consequences such as risk of a chronic manifestation of a major depression, social retreat, limitations in the bonding behavior, and behavioral disorders of the child. Therefore, an early detection of pregnant women at risk is warranted.
METHODS: Within a prospective study (FRAMES: Franconian Maternal Health Evaluation Studies), 1,100 pregnant women were interviewed with standardized questionnaires at three points of time: Prepartal (U1): from the 30 (th) week of pregnancy onwards, 48 - 72 hours (U2) postpartum (pp) und 6 - 8 months pp (U3). 554 women were included in the substudy Blue FRAMES, where an additional telephone interview at the 10 (th) day pp was conducted with a focus on symptoms relating to Baby Blues such as mood instability, irritability and concentration deficits. The Edinburgh Postnatal Depression Scale (EPDS) and the Hamilton Rating Scale For Depression (HAMD) were used for quantification of depressivity at each point of time.
RESULTS: EPDS values differed significantly (Friedman Test; chi (2) = 110.8; df = 2, p < 0,001) between the different examination points (Wilcoxon Test; U1 - U2: Z = -11.0; p < 0.001; U1 - U3: Z = -6.6; p < 0.001; U2 - U3: Z = -4,5; p < 0,001). Regarding EPDS values, higher values were observed prepartum (U1). After a decrease after two to three days postpartum (U2), values increased again. However, EPDS values six months postpartum (U3) were still lower than prepartum (U1). DISCUSSION: The observed EPDS values postpartum are comparable to results of other studies. The higher EPDS values prepartum have a good predictive value. There is a great need and possibility for improved prevention of postpartal disorders, when appropriately addressed in the prepartum period. Georg Thieme Verlag KG Stuttgart New York.