Smoking May Be a Factor in Postpartum Depression

Up to 80% of new mothers experience a brief bout of “baby blues” after childbirth, with sudden mood swings caused by changing hormone levels. However, 15% of new mothers may suffer from postpartum depression (PPD), with severe symptoms that can last for months and even years. Asking new mothers a few questions about the length and severity of their symptoms can help a pharmacist determine whether to advise her to seek treatment from her health-care provider. One of those questions might be asking the new mother if she smokes.

Risk factors for PPD include a stressful pregnancy, medical complications during childbirth, and alcohol or drug abuse problems. However, smoking also seems to plays a role, even if the link is not entirely clear.

Three students at the University of Minnesota College of Pharmacy examined the role of smoking in PPD and have published “Smoking and its effects on postpartum depression” in Advances on Pharmacy: Journal of Student Solutions to Pharmacy Challenges. Student pharmacists Elizabeth Swanson, Elizabeth Scott and Meredith Thompson reviewed 11 studies exploring the link between smoking and PPD.

The students chose the subject after noting that PPD research had focused on other prenatal health behaviors such as caffeine intake or vitamin use. They knew smoking was associated with an increased risk of other mood disorders and wondered how it affected PPD. Even though smoking poses several health risks during pregnancy, as many as 10% of all expectant mothers don’t quit.

Elizabeth Swanson"Since smoking is widely known as a risk factor for multiple disease states and conditions, we thought it would be interesting to explore the available evidence on whether smoking has a relationship with postpartum depression,” said Elizabeth Swanson.

After studying available literature, the authors concluded that there was a significant relationship between smoking and PPD, but that whether there was a cause and effect was harder to clarify. “While many studies have been able to find a definite correlation between smoking and postpartum depression, the causal relationship between the two still needs to be explored,” said Swanson.

Although “baby blues” and PPD share symptoms, such as anxiety, sadness, crying, and fatigue, mild depression after childbirth normally lasts for only a few days after birth. PPD symptoms are more severe. They may begin shortly after birth, but can also start much later and last for months. PPD symptoms include difficulty bonding with the baby, withdrawal from family and friends, loss of appetite, issues with sleep, irritability, severe anxiety, and panic attacks.

Women with PPD may need treatment with psychotherapy and antidepressants.