--- title: What increases the risk of depression after childbirth? | Niyora description: Premenstrual syndrome is the strongest known risk factor for postpartum depression, nearly doubling the risk. Violent experiences and unintended pregnancy are url: https://niyora.com/research/papers/risk-factors-of-postpartum-depression-and-depressive-symptoms-umbrella-review-of-2022/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - What increases the risk of depression after childbirth? Systematic review, 2022 # What increases the risk of depression after childbirth? Premenstrual syndrome is the strongest known risk factor for postpartum depression, nearly doubling the risk. Violent experiences and unintended pregnancy are also strong risk factors. Strong study design 3,272,093 people across 185 observational studies examining postpartum depression risk factors. ## What they did Umbrella review of 11 systematic reviews and meta-analyses covering 185 observational studies with 3,272,093 people, examining risk factors for postpartum depression. ## What they found Premenstrual syndrome had the strongest association with postpartum depression (odds ratio 2.20). Violent experiences came second (odds ratio 2.07), and unintended pregnancy third (odds ratio 1.53). Other risk factors with weaker evidence included Caesarean section, gestational diabetes, vitamin D deficiency, and anaemia during pregnancy. ## What it means for you Women with premenstrual syndrome should be considered at higher risk for depression after childbirth and monitored accordingly. The main limitation is that the certainty of evidence was low to very low for most risk factors, meaning we should be cautious about relying on them alone. 3,272,093 Total people studied 2.20 Odds ratio for postpartum depression if you have premenstrual syndrome 11 Systematic reviews and meta-analyses reviewed ## About the study Original title Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies Authors Gastaldon C, Solmi M, Correll CU et al. Journal The British journal of psychiatry : the journal of mental science Year 2022 Study design Systematic review Open access Yes Read the paper [doi.org/10.1192/bjp.2021.222](https://doi.org/10.1192/bjp.2021.222) Original abstract Background: Evidence on risk factors for postpartum depression (PPD) are fragmented and inconsistent. Aims: To assess the strength and credibility of evidence on risk factors of PPD, ranking them based on the umbrella review methodology. Method: Databases were searched until 1 December 2020, for systematic reviews and meta-analyses of observational studies. Two reviewers assessed quality, credibility of associations according to umbrella review criteria (URC) and evidence certainty according to Grading of Recommendations-Assessment-Development-Evaluations criteria. Results: Including 185 observational studies ( n = 3 272 093) from 11 systematic reviews, the association between premenstrual syndrome and PPD was the strongest (highly suggestive: odds ratio 2.20, 95%CI 1.81-2.68), followed by violent experiences (highly suggestive: odds ratio (OR) = 2.07, 95%CI 1.70-2.50) and unintended pregnancy (highly suggestive: OR=1.53, 95%CI 1.35-1.75). Following URC, the association was suggestive for Caesarean section (OR = 1.29, 95%CI 1.17-1.43), gestational diabetes (OR = 1.60, 95%CI 1.25-2.06) and 5-HTTPRL polymorphism (OR = 0.70, 95%CI 0.57-0.86); and weak for preterm delivery (OR = 2.12, 95%CI 1.43-3.14), anaemia during pregnancy (OR = 1.47, 95%CI 1.17-1.84), vitamin D deficiency (OR = 3.67, 95%CI 1.72-7.85) and postpartum anaemia (OR = 1.75, 95%CI 1.18-2.60). No significant associations were found for medically assisted conception and intra-labour epidural analgesia. No association was rated as 'convincing evidence'. According to GRADE, the certainty of the evidence was low for Caesarean section, preterm delivery, 5-HTTLPR polymorphism and anaemia during pregnancy, and 'very low' for remaining factors. Conclusions: The most robust risk factors of PDD were premenstrual syndrome, violent experiences and unintended pregnancy. These results should be integrated in clinical algorithms to assess the risk of PPD. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Vitamin D](https://niyora.com/research/topics/treatment-vitamin-d/)[Major depressive disorder](https://niyora.com/research/topics/comorbidity-major-depression/)[Pregnancy and postpartum](https://niyora.com/research/topics/comorbidity-postpartum/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Systematic review, 2021 Are there hormone changes that could explain PMDD or depression in women? Review, 1992 Is PMS really caused by hormones? Review, 1989 Are mental health conditions linked to the reproductive cycle? Case-control study, 2026 Does PMS increase the risk of depression after childbirth in women with a history of depression? Systematic review, 2022 Does having PMDD increase the risk of depression during pregnancy or after birth? Lab study, 2018 How does depression affect menstrual function and fertility in women? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗