JAMA Netw Open

Postpartum hormonal contraceptive use linked to increased depression risk

April 8, 2025

Study details: This population-based cohort study utilized nationwide Danish register data, including 610,038 primiparous women who gave birth between January 1, 1997, and December 31, 2022. Women with a history of depression within 24 months before delivery, multiple births, stillbirth, or a diagnosis of breast cancer or liver tumor were excluded. The study analyzed the association between hormonal contraceptive (HC) initiation within 12 months postpartum and the development of depression, defined by antidepressant prescription or hospital diagnosis.

Results: Of the participants, 40.7% initiated HCs within 12 months postpartum. HC initiation was associated with an increased risk of depression (adjusted hazard ratio [AHR], 1.49; 95% confidence interval, 1.42-1.56). The absolute risk of depression increased from 1.36% to 1.54%. AHRs for specific contraceptives were: combined oral contraceptives (COCs) 1.72, combined nonoral contraceptives (CNOCs) 1.97, and progestogen-only nonoral contraceptives (PNOCs) 1.40. Progestogen-only pills (POPs) showed a variable risk, initially reduced but increased later postpartum.

Clinical impact: The study highlights a significant association between postpartum HC use and increased depression risk, particularly with earlier initiation and specific types of HCs like COCs and CNOCs. These findings suggest the need for careful consideration and monitoring of mental health in postpartum women initiating HCs.

Source:

Larsen SV, et al. (2025, March 3). JAMA Netw Open. Postpartum Hormonal Contraceptive Use and Risk of Depression. https://pubmed.ncbi.nlm.nih.gov/40163119/