Mothers Of Twins And Triplets At Higher Risk Of Postpartum Depression

By Margarita Nahapetyan

Women who give birth to more than one baby at a time are 43 per cent more likely to develop postpartum depression within 9 months after labor, than mothers who deliver a single child, report U.S scientists at the Johns Hopkins Bloomberg School of Public Health.

Researchers analyzed the relationship between multiple births and development of maternal depressive symptoms and came to the conclusion that multiple births increased the risk of postpartum depression, and that very few women with depressive symptoms, in spite of the multiple births status, said that they had been consulting a mental health specialist or a family physician.

For the study, the Baltimore-based team of researchers, led by Dr. Yoonjoung Choi, analyzed data from the Early Childhood Longitudinal Study-Birth Cohort survey, which was carried out throughout the United States. The study involved more than 8,000 mothers, 7293 of whom gave birth to one infant, and 776 of those who had delivered two or more children. All babies were born in 2001.

The women have been surveyed nine months after giving birth. The experts measured depressive symptoms in all of them, using an abbreviated version of the Center for Epidemiologic Studies Depression (CES-D) scale. They also asked the study participants to fill out a standard questionnaire and report whether they had experienced the symptoms of depression or not.

When the results have been analyzed, the researchers found that 19 per cent of mothers with multiple babies developed moderate or severe symptoms of depression, compared to 16 per cent of women who gave birth just to one baby. As a result, women who delivered two or more babies, were 43 per cent more likely to suffer postpartum depression, compared to mothers of a single child. Mothers with multiple births in the study had twins or triplets, and no significant difference was found in postpartum depression rates between these two groups.

The study also found that:

• Women with a history of hospitalization for a mental health disorder, or with a history of drug or alcohol abuse, also were at an increased risk of developing severe postpartum depression.

• Non-Hispanic black mothers were more likely to develop the condition, compared to non-Hispanic white mothers.

• Women who were currently married, Hispanic or with a high household socioeconomic status, were less likely to develop depressive symptoms.

"Undergoing a high-risk pregnancy and delivering multiple births are stressful life events," Dr. Yoonjoung Choi said. "The unique demands of parenting multiple infants can result in high levels of parental stress, fatigue, and social isolation." The stress of delivering more than one child at a time is one reason that some mothers may experience postpartum depression, the scientists said. Multiple births can also be associated with in vitro fertilization, a process that often leads to stress of its own, they added.

Symptoms of postpartum depression, which affects approximately ten per cent of new moms, include loss of appetite, mood change, insomnia and isolation from family and friends, according to medical experts. Therapies available for the condition include psychotherapy, cognitive behavioral therapy and medication, and some women report that a combination of two works even better.

The study appears in the April 1 issue of the journal Pediatrics.