Multiple pregnancy increases postpartum depression risk, Japan study finds, highlighting need for support.

 

Meaning

Multiple pregnancy refers to carrying more than one fetus (e.g., twins or triplets). This condition can increase physical, emotional, and financial pressures on mothers, potentially heightening the risk of postpartum depression (PPD). The Japan Environment and Children’s Study explored how multiple pregnancies relate to maternal mental health after childbirth.

Introduction

Postpartum depression is a serious mental health condition affecting women after childbirth, characterized by persistent sadness, exhaustion, anxiety, and difficulty bonding with the baby. Multiple pregnancies often involve higher medical risks, complications, and caregiving demands. The Japan Environment and Children’s Study (JECS), a large national birth cohort study, examined whether mothers of twins or higher-order multiples are more likely to develop PPD due to increased physical strain, medical interventions, hormonal fluctuations, and stress levels. Understanding this link helps policymakers and healthcare providers improve maternal mental-health support.

Advantages

Although multiple pregnancies involve many challenges, the study acknowledges a few positive aspects:

1. Enhanced social support: Families, relatives, and healthcare teams often provide more attention and help knowing the demands of raising twins or multiples.

2. Frequent medical monitoring: Mothers with multiple pregnancies receive high-quality and regular prenatal care, helping detect complications early.

3. Stronger family bonding: Shared caregiving responsibilities may bring partners and family members closer.

Disadvantages

1. Increased physical burden: Higher chances of anemia, gestational diabetes, hypertension, and preterm delivery.

2. Higher emotional stress: Anxiety about babies’ health, NICU admission risks, and intense postpartum responsibilities.

3. Greater financial strain: Additional costs for medical care, baby supplies, and long-term caregiving.

4. Sleep deprivation: Feeding and caring for multiple infants significantly increases exhaustion.

Challenges

1. Medical complications: Preterm birth, low birth weight, and cesarean deliveries are more common, increasing maternal stress.

2. Cognitive overload: Managing feeding schedules, sleep routines, and medical appointments for more than one infant at the same time.

3. Limited resources: Families may struggle to access childcare, mental-health support, and financial assistance.

4. Emotional isolation: Mothers may feel overwhelmed and unable to express their distress due to societal expectations.

In-Depth Analysis

The JECS studied thousands of pregnancies across Japan, comparing mothers of singleton births to those with twins or multiples. The findings showed that multiple pregnancy was associated with a statistically higher risk of postpartum depression.

Reason for increased risk:

• Physiological factors: Hormonal changes are stronger in multiple pregnancies, affecting mood-regulation pathways.

• Higher medical interventions: Frequent hospital visits, risk of bed-rest, and complicated deliveries elevate emotional stress.

• Infant-related stress: Multiple infants increase sleep deprivation and reduce maternal rest, worsening mental health.

• Financial and social strain: Costs, reduced mobility, and limited social interaction contribute to depressive symptoms.

• Cultural factors in Japan: Many mothers feel pressure to manage childcare independently, limiting help-seeking behavior.

The study emphasizes that early screening, targeted counseling, and community support can significantly reduce PPD risk in mothers of multiples.

Conclusion

Multiple pregnancy is a significant risk factor for postpartum depression due to increased physical demands, emotional stress, and caregiving responsibilities. The Japan Environment and Children’s Study highlights the need for healthcare providers to monitor mental health closely in mothers of twins or higher-order multiples. Strengthening support systems, offering psychological services, and ensuring community involvement can help reduce the burden and promote healthier maternal outcomes.

Summary 

Multiple pregnancies increase the likelihood of postpartum depression, as shown in the Japan Environment and Children’s Study. Mothers carrying twins or multiples face greater physical strain, medical risks, financial pressures, and emotional stress, all contributing to higher PPD vulnerability. Early screening, strong social support, and improved mental-health interventions are essential to protect maternal well-being and ensure healthier outcomes for both mothers and infants.