Obstetric variables associated with bipolar affective puerperal psychosis. Blackmore et al. (2006) BJP 188, 32-36

Establishing clear risk factors for postpartum psychosis (PP) is important, both in helping us predict those at risk of developing postnatal illness and in helping to guide research into the causes of PP.  This study investigated a number of obstetric variables that may be associated with PP, in order to understand more about why following some pregnancies women experience PP, whilst the same women remain well after other pregnancies.

For the study, 129 women, all of whom had experienced at least one episode of PP, were recruited through APP.  Of the 129 women, 53 had also experienced a delivery unaffected by any major affective disturbance. We compared risk factors between deliveries that were followed by PP and deliveries unaffected by PP. Two significant risk factors for PP were identified: primiparity (i.e. being a first time mother) and experiencing a medical complication during delivery (e.g. breech presentation, foetal distress, cord accidents).

The next step is to design further studies that can explore what biological (possibly hormonal or immunological) and psychological mechanisms could account for these findings.