Postpartum depression among first-time mothers - results from a parallel randomised trial

Objectives: To compare the risk of postpartum depression among nulliparous women enrolled in a structured antenatal programme, with nulliparous women allocated to standard care as well as to identify obstetric characteristics in women at risk of developing postpartum depression. Method: A randomised controlled trial involving 1193 Danish nulliparous women. A total of 603 women attended the "Ready for Child program" and 590 received standard care. Data were collected from the ongoing local birth cohort at Aarhus University Hospital and from questionnaires mailed to the women attending the study. Results: No difference in postpartum depression was found between those who attended the intervention group and the reference group. Overall, being at risk of postpartum depression was associated with preterm birth, unscheduled caesarean section, low Apgar score, lack of pain relief during labour, experienced low attendance of the midwife in the delivery room, unprepared for hospital discharge, none or minor breastfeeding in the early postpartum period, insufficient knowledge about breastfeeding, poor or fair self-rated mental health, and uncertain or weak attachment to the newborn child. Conclusion: The findings suggest that a short general antenatal programme in pregnancy may not be sufficient to prevent postpartum depression six weeks after birth. However, there are several risk factors during the birth process and the early postpartum period that can help identify women at risk for developing depression. (C) 2015 Elsevier B.V. All rights reserved.