Causes and risk factors of postpartum psychosis

Biological factors

• Sudden hormonal changes after childbirth, including a drop in oestrogen and progesterone levels.
• Genetic vulnerability. This is particularly relevant for women with a family history of bipolar disorder or postpartum psychosis. Rates of up to 74% have been reported among women with bipolar disorder who also had a close relative (such as a mother or sister) who had experienced postpartum psychosis.
• Severe sleep deprivation. Disruption to the normal sleep-wake cycle may act as a trigger.
• An association with mood disorders such as bipolar disorder.

Clinical and psychiatric factors

• A previous diagnosis of bipolar disorder. Around 25–50% of women with bipolar disorder experience postpartum psychosis after giving birth.
• A previous episode of postpartum psychosis. A relapse rate of 50-60% has been reported.
• A sudden discontinuation or absence of preventative treatment.

Psychological and social factors

• Severe stress following childbirth and the transition to motherhood.
• High expectations of motherhood.
• Lack of family or social support.
• Stressful life events.

Obstetric and neonatal factors

• First childbirth (primiparity).
• A difficult or traumatic birth.
• Hospitalisation or health problems affecting the baby.