Cedars-Sinai researchers explore risk factors associated with mental health of new mothers

Cedars-Sinai investigators are examining the risk factors associated with mental health issues experienced by many women after giving birth.

"Maternal mental health has long been undervalued," said Sarah J. Kilpatrick, MD, PhD, chair of the Cedars-Sinai Department of Obstetrics and Gynecology. "While pregnancy is a normal part of many women's lives, it is also stressful for many reasons and associated with an increased risk for depression and anxiety, both before and after having the baby."

According to the Centers for Disease Control and Prevention, 11 percent of women who give birth each year report symptoms of postpartum depression. Many experts believe the condition is even more prevalent, but the stigma associated with mental illness can prevent new mothers from seeking help.

The need is so great that in 2017 Cedars-Sinai launched the Postpartum Depression Screening, Education and Referral Program to evaluate all women who give birth at the hospital - more than 6,500 each year. New mothers showing signs of moderate-to-severe depression are provided referrals for interventions that can include talk therapy, support groups, medication and lifestyle changes.

The precise causes and scope of depression associated with childbirth are not well understood. Physiological changes, including hormonal fluctuations before and after childbirth, are often considered major factors, but hormonal fluctuations alone don't explain the psychological and emotional decline some women experience.

That's why Cedars-Sinai researchers are investigating other potential risk factors, including the possible impact of high-risk pregnancies and the role inflammation or certain vitamin deficiencies may play in a new mother's mental state.

"Despite the higher prevalence of depression and anxiety in women who have perinatal complications, little research has explored the underlying causes that put so many women at risk," said Eynav Accortt, PhD, an assistant professor in the Department of Obstetrics and Gynecology, and a clinical psychologist. "Research is needed to provide a risk profile and to develop strategies for identifying and helping these mothers."

Accortt is serving as an investigator in the following studies

• Preeclampsia Research on Vitamin D, Inflammation and Depression

In this study, investigators will examine whether prenatal systemic inflammation and vitamin D deficiency put women at higher risk for developing preeclampsia-;a condition in pregnancy characterized by high blood pressure-;and postpartum depression.

• Postpartum Depression Quality Improvement Study

Researchers want to see how well the new Cedars-Sinai postpartum depression screening program is doing in identifying women at risk for the disorder and if improving nurse training in maternal mental health made a difference. The study is also looking at whether a woman's risk for postpartum depression increases if she is admitted to the Cedars-Sinai Maternal Fetal Care Unit or their newborns are in the Neonatal Intensive Care Unit.

• The Postpartum Heart Health Registry and Biorepository

Women who had pregnancy complications are being followed for 45 years to determine if they are at higher risk for developing postpartum depression, anxiety, post-traumatic stress disorder or heart disease.

"We hope our research findings will lead to better prevention and treatment for postpartum depression and anxiety," said Accortt. "These conditions not only affect the mother, but also the wellbeing of her baby and entire family."