Postpartum mental health after medically complicated pregnancy

Abstract Mental health is a crucial aspect of overall well-being. The postpartum period is a vulnerable time for women’s mental health, with poor mental health potentially impacting the long-term health of mothers and their children. Common postpartum mental disorders include depression, anxiety, and posttraumatic stress disorder (PTSD). Medical complications during pregnancy, such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), and anaemia, are prevalent and can make pregnancy, childbirth, and the postpartum periods particularly challenging, sometimes resulting in life-threatening situations for the mother and/or her baby. It is therefore plausible that women who experience a pregnancy complication may be at increased risk of also experiencing a postpartum mental health disorder. Published research indicates that HDP, GDM, and gestational anaemia may increase the risk of postpartum depression (PPD). There may be associations between a higher risk of anxiety and PTSD, but the evidence is unclear or under-researched. Postpartum mental health care is often neglected following medically complicated pregnancies, with a focus primarily on physical recovery. There are limited global guidelines addressing mental health care for mothers and their children, but growing recognition of the connection between medical complications and postpartum mental health has led to the development of some follow-up guidelines. Research is necessary to better understand postpartum mental health in women with medical complications during pregnancy. Until more is known, all pregnant women with medical complications should be considered at high risk for postpartum mental disorders and receive appropriate follow-up care. In brief Pregnancy complications like HDP, GDM, and anaemia may increase the risk of postpartum mental disorders, especially depression, however the evidence for anxiety and PTSD is limited. Women with medical complications in pregnancy should be considered at high risk for mental disorders and receive appropriate and timely screening and follow-up.