The Association Between Medically Assisted Reproduction and Postpartum Depression: A Register-Based Cohort Study

Objective

Undergoing medically assisted reproduction (MAR) has been linked to mixed mental health outcomes in women. We investigated the risk of postpartum depression (PPD) among mothers conceiving with MAR compared to mothers conceiving spontaneously.

Design

Register-Based Study.

Setting

Denmark.

Population

125 870 mothers with a PPD screening record who gave birth between 2015 and 2019.

Methods

We linked mothers' PPD screening records to national health registers and defined MAR conception linking childbirths to MAR treatments.

Main Outcome Measures

We defined PPD as an Edinburgh Postnatal Depression Scale score of ≥ 11. We performed logistic regression on the risk of PPD among mothers who conceived with MAR compared to spontaneous conception and further assessed variations according to duration, type, and indication for MAR.

Results

The study population included 10 977 mothers with MAR conception and 114 893 with spontaneous conception, of which 767 (7%) and 8767 (8%) had PPD. We found a lower risk (adjusted risk ratio 0.87, 95% CI [0.80–0.93]) of PPD among mothers with MAR conception compared to spontaneous conception, with smaller variations according to type, duration and indication for MAR.

Conclusions

We observed a lower risk of PPD among mothers with MAR conception compared to mothers with spontaneous conception. While it is unlikely that MAR itself is protective of PPD, women who seek MAR may have a strong desire and psychological preparedness for parenthood, which could explain the observed findings. Among mothers conceiving with MAR, PPD risk may vary depending on the type of MAR treatment and underlying reasons for seeking MAR.