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CPA: Researchers Find Association Between Duration of Labour, Time of Delivery, and Postpartum Psychosis By Louise Gagnon MONTREAL, QC -- October 20, 2004 -- Sleep deprivation is associated with postpartum psychosis, particularly in women who are susceptible to the condition, said researchers here on October 16th at the Canadian Psychiatric Association Annual Meeting. "What we hypothesised is that women who have sleep disruption at the time of delivery are more likely to have psychosis," said the study's principal investigator Verinder Sharma, MD, a psychiatrist for the Mood Disorders Program, Regional Mental Health Care, and professor of psychiatry, University of Western Ontario, London, Ontario, Canada. "We found that insomnia was the most frequent symptom, and it's one of the earliest signs of postpartum psychosis." Researchers performed a chart review of women who developed psychoses within 4 weeks of delivery and were admitted to the same hospital where they had delivered. The study enrolled 21 subjects who were matched for age and parity against controls who delivered at the same hospitals but did not have psychosis. The study excluded women who had a planned cesarean section, a stillbirth, or women who delivered prematurely. The researchers defined post-partum psychosis as an episode of bipolar disorder or schizoaffective disorder. Sleep loss has been implicated in the onset of puerperal psychosis, Dr. Sharma explained. A total of 57% of the women were delivering for the first time. Given first-time mothers had a longer duration of labour, it would make them more predisposed to developing postpartum psychosis, noted Dr. Sharma. Researchers found 87% of women reported insomnia, which preceded the development of psychosis in the majority of women. Anxiety was reported in 83% of subjects. There was a statistically significant difference in the time of delivery between women with puerperal psychosis and controls: women with puerperal psychosis were more likely to deliver at night (between 12:30 a.m. and 7:30 a.m.). Matched against controls, they were also more likely to have longer duration of labour -- 5 to 6.5 hours for controls and about 11 hours for women with puerperal psychosis. "If we pay attention to the issue of sleep deprivation, we will be able to prevent episodes of puerperal psychosis," said Dr. Sharma. "The next step is to conduct a study on prevention of post-partum psychosis by aggressively paying attention to sleep disruption." While researchers did not collect data on family history, Dr. Sharma noted that women with family histories of bipolar disorder are more likely to develop post-partum psychosis. The Ontario Mental Health Foundation funded the study. [Presentation title: "Duration of Labour, Time of Delivery, and Puerperal Psychosis." Abstract 24] E-mail this page to a friend or colleague! To print, use this version