Roberts TA, et al. - The purpose of this study is to explore the relationships of hormonal contraception with depression in the postpartum period. The outcome of this study suggests that the risk of major depression diagnosis and antidepressant utilization in the postpartum period varies with the type of hormonal contraception used. To depict the mechanisms of these association, further research is required.

Methods

• This study is a secondary investigation of insurance records from 75,528 postpartum women selected in the US military medical system, who delivered between October 2012 and September 2014.
• Women who used antidepressants or had a diagnosis of depression in the 24 months prior to delivery were not included in this study.
• They evaluated the relationship between hormonal contraception use with the subsequent antidepressant use or diagnosis with depression in the first 12 months postpartum utilizing Cox proportional hazards regression, with a time dependent covariate measuring exposure to hormonal contraception.

Results

• They recommended antidepressants to 7.8% of women and 5.0% were diagnosed with depression.
• In multivariable analysis adjusting for demographics, both antidepressant use and diagnosis with depression were related to: younger age, lower socioeconomic status, and a history of military service.
• Compared to women with no hormonal contraceptive use, use of utilization of onogestrel containing contraception was related to a higher risk of antidepressant use (Implant: adjHR:1.22(95%CI:1.06-1.41), p <: 001; Ring:1.45(1.16–1.80), p=.001).
• Utilization of norethindrone-only pills was related to a lower risk of antidepressant use (0.58(0.52-0.64), p < .001) and depression diagnosis (0.56(0.49-0.64), p < .001).
• Utilization of a levonorgestrel intrauterine system was related to a lower risk of depression diagnoses (0.65(0.52–0.82), p < .001).