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Postpartum psychosis risk greatest soon after birth

New mothers have the highest risk of developing psychotic illness in the first month after they give birth.

Postpartum psychosis risk greatest soon after birth

New mothers have the highest risk of developing psychotic illness in the first month after they give birth.

Postpartum psychosis, also referred to as puerperal psychosis or postnatal psychosis, is a mental illness that involves the rapid onset of psychotic symptoms in a woman following childbirth. It involves a complete break with reality. Though only about 1 in 1,000 women develop postpartum psychosis, the consequences can be grave for both mother and child. Mothers who lose touch with reality may harm themselves or their infant, and also run the risk of future episodes of psychosis.

To investigate when postpartum psychosis risk is greatest, and also look for factors that could help identify at-risk women, researchers from Stockholm examined population registers for 745,596 Swedish women who gave birth for the first time between 1983 and 2000.

There were 892 women, or 1.2 per 1,000 births, hospitalised for psychosis within 90 days of delivery. Nearly one-third of the women were hospitalised within a week of having their child, while 59 percent were hospitalised within two weeks of delivery.

Almost half had never been hospitalised for psychiatric problems before. For these women, the risk of being hospitalised for a psychotic episode within the first month after giving birth was 10 times greater than it was after their baby was three months old. These women were also at increased risk if they were 35 years or older but having a high birth weight baby or having diabetes seemed to be protective. This may be because women with diabetes are more closely monitored while pregnant.

Though it is still not clear why postpartum psychosis occurs, there's evidence that the huge drop-off in estrogen levels that occurs after delivery could be a factor. Moreover, there are no clear warning signs during pregnancy if a woman will develop postpartum psychosis, although risk may be greater for a woman who suffers trauma or other complications during delivery, as well as for women who have low birth weight babies. Not surprisingly, risk also seems to be higher for women whose babies die soon after birth.

A supportive network and good contact with the doctor during pregnancy is always important for the expecting woman. It is good for all women to know more about the condition and that it could happen even if it is rare.
 
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