Perceived social support and postpartum depression symptoms across geographical contexts: Findings from the 2016 Ohio Pregnancy Assessment survey

Abstract

Background The purpose of this study was to examine the association between perceived social support and postpartum depression symptoms (PDS) and to understand how this association may differ for urban, suburban, rural Appalachian, and rural non‐Appalachian women in Ohio. Methods Data were obtained via the 2016 Ohio Pregnancy Assessment Survey (n = 3382), a representative sample of postpartum women in Ohio. We conducted bivariate analyses to assess the associations between self‐perceived social support and PDS, and covariates. Univariate and multivariate logistic regressions were conducted using a modified Poisson distribution to estimate the association between social support and PDS, adjusting for sociodemographic characteristics. We also examined geographical context as an independent predictor of PDS and as an effect modifier for the association between social support and PDS. Results 15.6% of survey respondents experienced PDS. Women with low levels of social support had slightly higher prevalence (aPR: 1.4, 95% CI: 1.0‐2.1) of PDS compared to women with high social support. Geographic context was an independent predictor of PDS; women in rural Appalachia had significantly lower prevalence (aPR: 0.5, 95% CI: 0.2‐0.9) of PDS compared to women in urban areas. We did not find that geographical context modified the relationship between social support and PDS (Wald P = .5). Conclusions Low social support was associated with increased PDS but did not reach statistical significance. Women living in rural Appalachia had a lower prevalence of PDS. Future studies should explore the reasons for lower rates of PDS in rural Appalachia.

Comparing maternal factors associated with postpartum depression between primiparous adolescents and adults: A large retrospective cohort study

“…Our finding that adolescents living in rural areas had lower odds of experiencing PPD warrants furthermore study. While this finding aligns with previous research demonstrating lower rates of PPD in rural women compared with their urban counterparts, it raises important questions with respect to the influence of limited access to maternity care services in rural communities 41,42 . Studies have shown that rural postpartum women face barriers in seeking healthcare services, including depression screening and access to mental health care 43 .…”

“…While this finding aligns with previous research demonstrating lower rates of PPD in rural women compared with their urban counterparts, it raises important questions with respect to the influence of limited access to maternity care services in rural communities. 41,42 Studies have shown that rural postpartum women face barriers in seeking healthcare services, including depression screening and access to mental health care. 43 With the increasing challenges posed by hospital and obstetric department closures as well as workforce shortages in rural areas, the availability and quality of maternal health services may be compromised, leading to a potential underestimation of PPD prevalence in these communities.…”