Can reporting mood swings during oral contraceptive use predict peripartum depression? Results from the Swedish longitudinal cohort study Mom2B

Peripartum depression (PPD) is one of the most common pregnancy complications; nevertheless, it often goes underdiagnosed. Pinpointing important correlates is crucial for early risk identification and pathophysiology understanding. We aimed to investigate the association between self-reported mood swings during oral contraceptive (OC) use and peripartum depressive symptoms (PPDS).

We used data from the Swedish longitudinal cohort study Mom2B. 3829 women who had reported previous usage of OCs were included. Self-reported mood swings during OC use were assessed through a single question, and PPDS were evaluated using established cut-offs of the Edinburgh Postnatal Depression Scale (EPDS).

Self-reported mood swings during OC use were associated with PPDS at gestational weeks 12-22 (OR = 1.30, 95% CI, 1.01-1.66), 24-34 (OR = 1.37, 95% CI, 1.10-1.71) and 36-42 (OR = 1.39, 95% CI, 1.05-1.82) as well as at postpartum weeks 6-13 (OR = 1.46, 95% CI, 1.12-1.92) and 24-35 (OR = 2.07, 95% CI, 1.43-2.99). Interestingly, self-reported mood swings during OC use were associated with higher odds for newly developed PPDS in early postpartum (OR for weeks 6-13 = 1.92, 95% CI: 1.19-3.08).

Women with self-reported mood swings during OC use have higher risk of experiencing depressive symptoms across the peripartum period and twice the risk of newly developed PPDS during the early postpartum, adding to current evidence of a hormonal sensitive subgroup of women and the opportunity to use this simple question in future predictive efforts.