The Association between Depo-Provera and Postpartum Depressive Symptoms
ACOG ePoster. Ross C. 04/27/18; 211432; 2G
Carolyn Ross
Carolyn Ross
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Abstract
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Introduction: Prior studies investigating the effects of Depo-provera (DMPA) on mood have demonstrated conflicting results. We hypothesize that receipt of DMPA during the immediate postpartum period is associated with the development of postpartum depressive symptomatology.

Methods: We conducted a retrospective cohort study of women who presented to an academic outpatient clinic associated with Northwestern University for prenatal care between January 1, 2008 and December 31, 2014 who underwent a routine postpartum depression screen using the Patient Health Questionnaire-9 (PHQ-9) at their 6-week postpartum visits. A score of at least 10 defined a positive screen. Bivariable and multivariable analyses were performed to examine the relationship between DMPA receipt and postpartum depressive symptomatology.

Results: Of the 5103 women that met inclusion criteria, 410 (8.0%) received DMPA prior to being discharged from the hospital after delivery. Receipt of DMPA was not associated with a difference in the frequency of a positive depression screen at the postpartum visit (4.5% vs 6.1%, P=.25). This remained true after controlling for potential confounders (positive antenatal depression screen, age, BMI at delivery, gestational diabetes, nulliparity, public insurance, race, and preterm birth). Using an alpha of .05 and a beta of .20, this study had 80% power to detect a two-fold increase in the frequency of postpartum depressive symptomatology.

Conclusion/Implications: Receipt of DMPA immediately postpartum is not associated with increased postpartum depressive symptomatology at the 6-week postpartum visit.
Introduction: Prior studies investigating the effects of Depo-provera (DMPA) on mood have demonstrated conflicting results. We hypothesize that receipt of DMPA during the immediate postpartum period is associated with the development of postpartum depressive symptomatology.

Methods: We conducted a retrospective cohort study of women who presented to an academic outpatient clinic associated with Northwestern University for prenatal care between January 1, 2008 and December 31, 2014 who underwent a routine postpartum depression screen using the Patient Health Questionnaire-9 (PHQ-9) at their 6-week postpartum visits. A score of at least 10 defined a positive screen. Bivariable and multivariable analyses were performed to examine the relationship between DMPA receipt and postpartum depressive symptomatology.

Results: Of the 5103 women that met inclusion criteria, 410 (8.0%) received DMPA prior to being discharged from the hospital after delivery. Receipt of DMPA was not associated with a difference in the frequency of a positive depression screen at the postpartum visit (4.5% vs 6.1%, P=.25). This remained true after controlling for potential confounders (positive antenatal depression screen, age, BMI at delivery, gestational diabetes, nulliparity, public insurance, race, and preterm birth). Using an alpha of .05 and a beta of .20, this study had 80% power to detect a two-fold increase in the frequency of postpartum depressive symptomatology.

Conclusion/Implications: Receipt of DMPA immediately postpartum is not associated with increased postpartum depressive symptomatology at the 6-week postpartum visit.
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