A simple blood test may soon be able to predict postpartum depression before symptoms appear, hinting at a future where treatments could shift from response to prevention for the condition, the most common complication of childbirth, affecting about one in seven women after delivery.
Shame, stigma, and lack of awareness can delay or deter diagnosis, causing long-term effects on both mother and child, yet research paving the way for the blood test has been piling up for a decade, reports WebMD.
Five years ago, scientists were able to identify epigenetic biomarkers (indicators in our DNA that reflect changes in how genes are expressed) and which can predict postpartum depression with 80% accuracy in the third trimester of pregnancy, according to their 2020 study in Psychiatry Research.
Results from several studies found that these biomarkers were able to predict postpartum depression in women with a history of depression and in those who, at the time of the test, didn’t show any signs of depression.
If these findings can be used to create a standardised blood test, then high-risk patients would be able to seek treatment before symptoms occur, said Lauren Osborne, MD, second author of the 2020 study and vice chair of clinical research in the Department of Obstetrics and Gynaecology at Weill Cornell Medicine in New York City.
“Such a test would alert the clinical care team to the potential risk, helping guide early and targeted intervention and bringing the power of precision medicine to psychiatry,” said Jamie Maguire, PhD, a professor of neuroscience at Tufts University School of Medicine in Boston. (Maguire did not take part in the study.)
It could also go a long way toward ending stigma, said Jennifer Payne, MD, a professor at the University of Virginia and an expert in reproductive psychiatry.
A blood biomarker provides an objective measure and a biological cause, highlighting the condition as a medical issue that needs treatment.
Two studies led by Payne and Osborne, one local, already under way, and one national, planned to start shortly, will explore the test’s potential. If they are successful, the test could become available in as little as a few years.
Research suggests there are at least two forms of postpartum depression, each responding to different treatments, said Payne.
One is more likely to happen in women with a history of depression, while the other, described as “hormone-dependent”, affects patients with no previous mental health issues. The latter is more likely to respond to hormone-based medications.
How existing treatments could work with test
Treatment for postpartum depression typically uses medication along with therapy.
For patients with a history of depression or anxiety, continuing or resuming medications through pregnancy can be an option.
Common antidepressants – including citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac) and sertraline (Zoloft) – are often prescribed during pregnancy and generally considered safe, with benefits largely outweighing the risks to both mom and baby.
Patients with hormone-dependent postpartum depression have a dedicated drug treatment: In 2023, the FDA approved zuranolone (Zurzuvae) for postpartum depression. The drug contains neuroactive hormones that help improve mood regulation.
With a biomarker test, patients with positive results could start the two-week zuranolone treatment in the hospital after giving birth, said Morgan Patterson, MD, director of the Perinatal Mood and Anxiety Disorders Programme at the University of North Carolina School of Medicine.
Psychotherapy, especially interpersonal therapy and cognitive behavioural therapy (CBT), can give patients better coping tools and help moms identify and change negative thought patterns.
“Therapy can help normalise a mother’s experience, help her to process her emotions, and address any possible reproductive trauma,” said Marilyn Cross Coleman, a therapist, perinatal treatment specialist, and owner of Shameless Mama Wellness in California.
Trauma caused by a serious birth complication that endangers either the mother or child can increase the risk of postpartum depression.
In some cases, group therapy is especially effective. Many women suffer in silence due to feelings of shame, and sharing their experience with other moms helps them know they’re not alone.
A biomarker test could lead pregnant women to seek mental health support early, which is crucial because finding care can take months, Osborne said.
Another huge thing that helps with postpartum depression is also hard for most new moms to come by: sleep.
Research shows that sleep disturbances put women at a higher risk of postpartum depression. A nightly four- to five-hour block of uninterrupted sleep can effectively stave off symptoms, according to a 2024 study.
New moms need a plan to prevent or treat postpartum depression, Cross Coleman said, because the longer symptoms fester, the more serious the condition can become.
WebMD article – We May Soon Have a Blood Test to Predict Postpartum Depression (Open access)
See more from MedicalBrief archives:
US sets price for (costly) new postpartum depression pill
Perinatal depression: mums, dads, babies all at risk – London meta-analysis
Postpartum depression influenced by birthing season