Adverse Childhood Life Events and Postpartum Mood Episodes among Women with Bipolar Disorder

Background:
The relationship between adverse childhood life events (ACLEs) and postnatal depression (PND) is well established. However, relatively little research has focused on examining this relationship among women with bipolar disorder (BD), who are at high risk during the postpartum period of both PND and postpartum psychosis (PP). We aimed to examine relationships between ACLEs and the occurrence of postpartum mood episodes among a large sample of women with BD.

Methods:
Participants were a subset of women taking part in the Bipolar Disorder Research Network study. All women were interviewed using the SCAN interview to obtain detailed information about lifetime psychopathology. They were also asked about the occurrence of postpartum mood episodes and experience of 13 ACLEs. We compared the prevalence of ACLE’s among women with BD who remained well postpartum (n=392) and those with a lifetime history of PND (n=518) or PP (n=325).

Results:
Significantly more BD women with a history of PND reported experiencing a death of a friend (p=.049), separation of parents (p=.027) and sexual abuse (p=.042) in childhood than BD women who remained well postpartum. In contrast, there were no significant differences in the frequency of reporting childhood life events between those who remained well postpartum and those with a history of PP.

Conclusions:
Sexual abuse, death of a friend and parental separation in childhood appear to be associated with PND but not PP in women with BD. Establishing ACLEs history in clinical practice could have important implications for illness management of BD in women during the perinatal period.