Alice Goodman

May 20, 2011

May 20, 2011 (Washington, DC) — Cigarette smoking should be a tip-off for the possibility of postpartum depression, according to a survey from the Pregnancy Risk Assessment Monitoring System. Results of a study suggesting this were presented here at American Congress of Obstetricians and Gynecologists 59th Annual Clinical Meeting.

The large survey showed that nearly 1 of every 3 mothers who reported smoking more than 10 cigarettes per day also had symptoms of clinical depression. Depression was more likely among heavier smokers who were younger, who were non-Hispanic black, and who had low levels of education.

"Our study suggests that screening and treatment of depression should be considered in all smoking-cessation programs that target new mothers," lead author Diana Cheng, MD, from the Maryland Department of Health and Mental Hygiene in Baltimore, told meeting attendees. The findings also suggest that healthcare workers should be alert to the possibility of postpartum depression in new mothers who are heavy smokers, and prescribe treatment accordingly, she added.

The study was based on a survey of a random sample of 8074 new mothers in Maryland who delivered babies between 2004 and 2008. Participants completed the survey between 2 and 9 months after delivery.

Fourteen percent of respondents reported smoking. Women were considered to have depression if they answered questions about depressive symptoms (mood and lack of interest) with "often" or "always". Compared with nonsmoking, heavier smoking was associated with 2 to 3 times the prevalence of depression (P < .05). Depression was strongly associated with the number of cigarettes smoked; it was found in 13% of nonsmokers, 22% of light smokers (10 or fewer cigarettes per day), and 29% of those who smoked more than 10 cigarettes per day.

The prevalence of depression was highest among heavier smokers who were younger than 20 years of age (41%) and were non-Hispanic blacks (39%). Depression was also strongly associated with education level: it was found in 46% of women who did not finish high school and in 9% of college graduates.

Postpartum depression is of great concern because it increases the risk of developing bipolar disorder and other psychosis, said Kristie Baisden, DO, chief resident at Georgetown University School of Medicine in Washington, DC. At the meeting, Dr. Baisden presented a poster on risk factors for postpartum depression. Her research on more than 900 women found that unemployment, being older than 35 years of age, and having any history of anxiety or depression increased the risk for postpartum depression.

"It is important to recognize and treat postpartum depression to avoid worsening mental health and subsequent problems," she stated.

Dr. Cheng and Dr. Baisden have disclosed no relevant financial relationships.

American Congress of Obstetricians and Gynecologists (ACOG) 59th Annual Clinical Meeting: Abstracts 64 and 125. Presented May 3, 2011.


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