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There is a bidirectional association between premenstrual disorders (PMDs) and perinatal depression (PND), according to a study published online March 28 in PLOS Medicine.
Qian Yang, M.D., from the Karolinska Institute in Stockholm, and colleagues investigated the bidirectional association between PMDs and PND using data from women with singleton pregnancies identified in the Swedish Medical Birth Register (2001 to 2018). The analysis included 10 pregnant women without PND (849,482 controls), individually matched to each PND case (84,949 cases) on maternal age and calendar year using incidence density sampling.
The researchers found that PMDs were identified in 2.9 percent of women before pregnancy among women with PND and 0.6 percent among controls. PMDs were associated with a significantly higher risk for subsequent PND (odds ratio, 4.76). At a mean follow-up of 7.40 years, newly diagnosed PMDs among women with PND was more common than among controls (incidence rate, 7.6 versus 3.8 per 1,000 person-years). Women with PND had a higher risk for subsequent PMDs versus matched controls (hazard ratio, 1.81). This association was bidirectional for both prenatal and postnatal depression and was stronger among women without a history of psychiatric disorders. While attenuated, significant bidirectional associations persisted in sibling comparisons.
“Preconception and maternity care providers should be aware of the risk of developing PND among women with a history of PMDs,” the authors write. “Moreover, health care providers may inform women with PND about the potential risk of PMDs when menstruation returns after childbirth.”
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