Postpartum Depression Research Roundup: March 6, 2025

In this Research Roundup, we explore new studies examining postpartum depression (PPD), including the potential impact birth complications and life factors have on its development.

Drug Use, History of Depression Strong Indicators in the Development of PPD

A new study found that psychological factors were the strongest predictors of PPD in women in Mashhad, Iran. The population-based, case-control study investigated PPD among 108,952 women using data from 2017 to 2024.

Among the women evaluated, 3407 were diagnosed with PPD and were matched with an equal number of controls. The Edinburgh Postpartum Depression Scale was used to identify both cases and controls, with scores greater than 12 indicating PPD.

In identifying risk factors, the factor with the highest odds ratio (OR) was drug use, with an OR of 5.76. History of depression had an OR at 5.31. Reports of psychological distress (OR = 4.94) and domestic violence (OR = 4.08) followed closely, and anxiety had an OR of 2.48. Maternal age being less than or equal to aged 20 was associated with an OR of 1.76, and obstetric factors including having a history of abortion (OR = 1.25), cesarean delivery (OR = 1.22), preterm birth (OR = 1.99), and twin births (OR = 2.10) were all considered significant risk factors in developing PPD.

Women who lived in metropolitan areas exhibited higher odds (OR = 1.54) of developing PPD than women in smaller cities, where rural areas were associated with a reduced risk (OR = 0.52).

“Early intervention strategies addressing psychological and social stressors can help reduce the burden of PPD and improve maternal and child outcomes,” the study authors concluded.

Reference

1. Moradi A, Norouzi M, Farkhani EM. Identifying risk factors for postpartum depression in Mashhad, Iran, 2017-2024: a population-based case-control study. Arch Public Health. 2025;83(1):58.

Weight Bias Internalization and PPD Influence Perceived Weight Stigma

A recent study found that the relationship between perceived weight stigma and disordered eating behaviors were heavily impacted by weight bias internalization and PPD. The cross-sectional study involved 507 postpartum women who completed 4 self-reported questionnaires: the perceived weight stigma questionnaire, weight bias internalization scale, Edinburgh postpartum depression scale, and Dutch eating behavior questionnaire.

Of the 507 participants, 4.7% were classified on the body mass index (BMI) as underweight, 61.1% were classified at a normal weight, 27.8% were classified as overweight, and 6.3% were classified as obese. The participants who were overweight and obese reported higher levels of weight bias internalization than those categorized as normal weight or underweight. The findings indicate that perceived weight stigma did not directly lead to disordered eating behaviors but was fully mediated by weight bias internalization and PPD. Weight stigma was associated with increased weight bias internalization (β = 0.31, P <0.0001) which in turn heightened PPD (β = 0.25, P < 0.0001), leading to restrained (β = 0.15, P < 0.0001), emotional (β = 0.22, P < 0.0001) and external eating behaviors (β = 0.28, P < 0.0001).

“The results of this study may draw the attention of obstetricians to perinatal weight stigma by highlighting perceived weight stigma, weight bias internalization, and PPD as risk factors for disordered eating behaviors in the postpartum period,” said the study authors.

Reference

1. Peng J, Tan X, Ning N, et al. Perceived weight stigma and disordered eating behaviors among postpartum women: the mediating role of weight bias internalization and postpartum depression. Int J Nurs Stud Adv. 2025;8:100306.

Maternal Birth Complications Associated With Higher Risk of Developing PPD

A new study found that mothers who experience a birth complication are more likely to develop PPD. The systematic narrative review and meta-analysis included 61 studies, covering 1,853,282 participants. The complications were categorized into 4 types: cesarean delivery, preterm birth, pain, and laceration.

The overall association between maternal birth complications and PPD had an OR of 1.47. Nonemergency cesarean deliveries (n = 1,792,725) are linked to increased PPD risk (OR = 1.3), but emergency cesarean deliveries (n = 14,199) showed a stronger association (OR = 1.48). Preterm birth (n = 39,291) presented the highest risk factor for PPD (OR = 1.97), followed by pain-related complications (n = 3708, OR = 1.18).

The study authors concluded by saying, “The current narrative review and meta-analysis characterize the importance of maternal birth complications as an indicator of PPD risk in women. However, the present findings also highlight the need for additional research to further clarify the strength of association between types of maternal birth complications and PPD, as well as additional variables increasing vulnerability in women.”

Reference

1. Cárdenas EF, Yu E, Jackson M, et al. Associations between maternal birth complications and postpartum depressive symptoms: a systematic narrative review and meta-analysis. Womens Health (Lond). 2025;21:17455057251320801.