For women with bipolar disorder, childbirth can be a high risk time of recurrence of mood disorder. Admission to psychiatric hospital with an episode of bipolar disorder is 23 times more likely in the month following delivery compared to any other time in a woman’s life.
Unfortunately, the specific causes and triggers of mood episodes that occur in relation to childbirth are not well understood. However, we know that genetic factors, the big hormonal changes that occur after having a baby and sleep disruption may play an important role.
For many years our research has had a particular focus on finding out more about the factors that make women with bipolar disorder more or less likely to experience episodes of illness in relation to childbirth.
As part of our programme, we conducted the UK's first prospective study to assess a wide range of potential risk factors for episodes of postpartum psychosis and postnatal depression in women with bipolar disorder. Women who participated in this research were interviewed during their pregnancy and again following their delivery, enabling the collection of very rich clinical data across the perinatal period. Some of the factors being assessed in this study include sleep loss during the perintal period, medication use, obstetric factors, illness history and psychosocial factors, such as stressful life events.
Publications resulting from our pregnancy and childbirth research include:
Perry, A., Gordon-Smith, K., Lewis, KJS., Di Florio, A., Craddock, N., Jones, L., & Jones, I. (2024). Perinatal sleep disruption and postpartum psychosis in bipolar disorder: Findings from the UK BDRN Pregnancy Study. Journal of Affective Disorders, 346, 21-27. https://doi.org/10.1016/j.jad.2023.11.005
Casanova Dias, M., Kelson, M., Gordon-Smith, K., Perry, A., Craddock, N., Jones, L., Di Florio, A. and Jones, I. (2023). Borderline personality traits are differently associated with postpartum psychosis and postpartum depression episodes in women with bipolar disorder. Journal of Affective Disorders, 328, 81-86. https://doi.org/10.1016/j.jad.2023.01.124
Perry, A., Gordon-Smith, K., Di Florio, A., Craddock, N., Jones, L., & Jones, I. (2021). Mood episodes in pregnancy and risk of postpartum recurrence in bipolar disorder: The Bipolar Disorder Research Network Pregnancy Study. Journal of Affective Disorders, 294, 714–722. https://doi.org/10.1016/j.jad.2021.07.067
Perry A., Gordon-Smith K., Di Florio A., Fraser C., Craddock N., Jones L. and Jones I. Adverse childhood experiences and postpartum depression in bipolar disorder. (2020) Journal of Affective Disorders, 263: 661-666. https://doi.org/10.1016/j.jad.2019.11.042
Gordon-Smith K, Perry A, Di Florio A, Forty L, Fraser C, Casanova-Dias M, Warne N, MacDonald T, Craddock N, Jones L and Jones I. Symptom profile of postpartum and non-postpartum manic episodes in bipolar I disorder: a within-subjects study (2020). Psychiatry Research, 284. https://doi.org/10.1016/j.psychres.2020.112748
Perry A, Gordon-Smith K, Webb I, Fone E, Di Florio A, Craddock N, Jones I and Jones L. (2019) Postpartum psychosis in bipolar disorder: no evidence of association with personality traits, cognitive style or affective temperaments. BMC Psychiatry, 19 (1): 395. 10.1186/s12888-019-2392-0
Di Florio, A., Gordon, Smith, K., Forty, L., Kosorok, M.R., Fraser, C., Perry, A., Bethell, A., Craddock, N., Jones, L. and Jones, I. (2018) Stratification of the risk of bipolar disorder recurrences in pregnancy and postpartum. British Journal of Psychiatry. 213, 542-547. 10.1192/bjp.2018.92
Lewis, K.J.S., Di Florio, A., Forty, L., Gordon-Smith, K., Perry, A., Craddock, N., Jones, L and Jones, I. (2018). Mania triggered by sleep loss and risk of postpartum psychosis in women with bipolar disorder. Journal of Affective Disorders, 225, 624-629. https://doi.org/10.1016/j.jad.2017.08.054
Perry, A., Gordon-Smith, K., Di Florio, A., Forty, L., Craddock, N., Jones, L. and Jones, I. (2016) Adverse childhood life events and postpartum psychosis in bipolar disorder. Journal of Affective Disorders, 205, 69-72. https://doi.org/10.1016/j.jad.2016.06.061
Di Florio, A., Jones, L., Forty, L., Gordon-Smoth, K., Robertson Blackmore, E., Heron, J., Craddock, N. and Jones, I. (2014) Mood Disorders and Parity - A clue to the aetiology of the postpartum trigger. Journal of Affective Disorders. 152-154, 334-339. https://doi.org/10.1016/j.jad.2013.09.034
Di Florio, A., Forty, L., Gordon-Smith, K., Heron, J., Jones, L., Craddock, N. and Jones, I. (2013) Perinatal episodes across the mood disorders spectrum. JAMA Psychiatry, 40(2), 168-175. 10.1001/jamapsychiatry.2013.279