Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum

Maternity blues have been described as a relevant risk factor for postpartum depression. Information regarding the influence of maternity blues on the onset and course of clinical postpartum anxiety disorders is scarce. The goal of this study was to determine whether maternity blues significantly predict postpartum depression and anxiety disorders in the first 3 months after delivery in a German sample. Demographic, psychiatric, and obstetric correlates of maternity blues were also investigated.

Maternity blues were assessed 2 weeks after delivery in a community sample of 853 women using a telephone interview and the Patient Health Questionnaire-Depression. Depression and anxiety disorders were diagnosed according to DSM-IV criteria over the first 3 months following delivery. A two-stage screening procedure was applied. In a first stage, the Patient Health Questionnaire-Depression, the Edinburgh Depression Scale, and two anxiety-screening instruments were employed. In the case of clinically relevant scores, the Structured Clinical Interview for DSM-IV was administered in a second stage.

The estimated prevalence rate of maternity blues among German women was 55.2%. We found a significant association between maternity blues and postpartum depression (odds ratio: 3.8) and between maternity blues and anxiety disorders (odds ratio=3.9).

Based on our predominantly middle class low-risk sample, maternity blues prevalence may be underestimated. Retrospective assessment of maternity blues 2 weeks postpartum might lead to biased results.

Women with maternity blues should be carefully observed in the first weeks postpartum with the aim of identifying those at risk of developing postpartum depression/anxiety disorders and providing treatment at an early stage of the disorder.