Timing of antidepressant initiation postpartum and maternal mental health outcomes up to 18 months after childbirth

• Zeenat F Chatha ^[1] ; Nhung TH Trinh ^[1] ; Sina Rostami ^[4] ; Veerle Bergink ^[2] ; Alexis Carson ^[1] ; Per Magnus ^[3] ; Angela Lupattelli ^[1]
  1. [1] University of Oslo

     University of Oslo

     Noruega

     
  2. [2] Icahn School of Medicine at Mount Sinai

     Icahn School of Medicine at Mount Sinai

     Estados Unidos

     
  3. [3] Norwegian Institute of Public Health

     Norwegian Institute of Public Health

     Noruega

     
  4. [4] Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway b Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 40, Nº 2, 2026, págs. 1-9
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2026.100352
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  • Background and Objectives: Evidence on postpartum antidepressant effectiveness is limited. We sought to deter- mine the association between different timings of antidepressant initiation within the 0–6 months postpartum and mental outcomes at 6- and 18-months following childbirth.

    Methods: Using data from the Norwegian Mother, Father and Child Cohort Study (MoBa) linked to a sub-sample of MoBa Genetics, we included 1146 women with psychiatric history before and/or during early pregnancy: 154 (13.4%) antidepressant initiators in the 0–6 months postpartum (37.0% within 0–3, and 63.0% within 4–6 months), and 992 (86.6%) with unmedicated new mental illness episode within same period. Depression/anxiety symptom outcomes at 6 and 18 months postpartum were self-reported. To control for measured confounding, we fit linear and modified Poisson models using overlap weighting, overall and stratified by polygenic score for antidepressant response.

    Results: Antidepressant initiators within 0–3 months postpartum had reduced severity of depression/anxiety symptoms at 6, but not at 18 months postpartum, compared with unmedicated women (weighted mean differ- ence (MD): -0.23, 95% CI = -0.39, -0.06) and a 44% lower risk of having active, clinically relevant depressive/ anxiety symptoms at 6 months (weighted RR= 0.56, 95% CI = 0.35, 0.91). No association was observed for initiation at 4–6 months postpartum at the 6-month assessment. The associations were evident only among women having high polygenic score for positive antidepressant response (weighted MD: -0.50, 95% CI: -0.84, -0.16), and that persisted at 18 months.

    Conclusions: Initiation of antidepressant in first 3 months postpartum, but not in months 4–6, is associated with reduced severity of depression/anxiety symptoms at 6 months post-delivery. Effects were most evident among women with higher polygenic scores; however, these findings are exploratory and warrant larger studies.