OBJECTIVES: Postpartum depression (PPD) is a form of chronic depression that occurs during or after pregnancy. Risk factors include personal or family history of depression/PPD, bipolar disorder, and lack of financial/social support. Treatment options for PPD include psychotherapy, antidepressants, and Zulresso. Patients with PPD that are also diagnosed and hospitalized for a mood disorder might suffer from worse mental health outcomes than those who are not. This study aims to assess mental health outcomes and treatments utilized by patients with a PPD diagnosis and hospitalization for a mood disorder.

METHODS: US-based patients diagnosed with PPD after giving birth and with a mood disorder diagnosis between 1/8/2021-1/8/2024 were identified in the TriNetX federated network of deidentified EHR data. Patients were categorized by those hospitalized on the same day of mood disorder diagnosis (N=10,740), and those that were not hospitalized (N=24,920). Cohorts were 1:1 propensity score matched on age, sex, race, and bipolar or schizophrenia diagnosis to adjust for confounding. The risks of suicidal thoughts/actions, self-harm, and seeking psychiatric care were evaluated.

RESULTS: In the matched analysis, a hospitalization for a mood disorder was associated with an increased risk of suicidal thoughts/actions (RR=2.264, 95%CI:1.707,3.002), self-harm (RR=2.06, 95%CI:1.411,3.008), and seeking psychiatric care (RR=1.356, 95%CI:1.232,1.494). Additionally, the hospitalized patients were treated with an SSRI (44.93%) followed by psychotherapy (11.18%) and Bupropion (9.04%). Zulresso, one of two FDA approved drugs for treatment of PPD, was used to treat 0.07% of patients.

CONCLUSIONS: PPD patients hospitalized for a mood disorder are more likely to suffer from negative mental health outcomes compared to those with who are not hospitalized. Additionally, PPD patients that are hospitalized are more likely to be prescribed SSRIs than Zulresso. More research is needed to improve mental health outcomes of PPD patients and determine whether outcomes differ based on treatments.