The association between pregnancy intendedness and experiencing symptoms of postpartum depression among new mothers in the United States, 2009 to 2011

Abstract

Postpartum depression (PPD) is a form of major depressive disorder affecting approximately 13% of women worldwide. Unintended pregnancies, reaching close to 50% of the pregnancies in the United States, have become a major health concern. While many physiologic and psychosocial causes have been analyzed, few studies have examined the relationship between unintended pregnancy and symptoms of PPD.A cross-sectional study was conducted using surveillance data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) from 2009 to 2011. The PRAMS population-based random sample included women who have had recent live births and is representative of 78% of the United States population. The chi-squared test was used to examine bivariate associations. Binary logistic regression was utilized to study unadjusted and adjusted associations between PPD and pregnancy intendedness, as well as other demographic and clinical characteristics of mothers in the sample. Multicollinearity in the adjusted model was evaluated using variance inflation factors. Sampling weights were used to account for PRAMS’ complex sampling design.Of the 110,231 mothers included in the sample, only 32.3% reported desiring the pregnancy at the time of conception. Women with pregnancies categorized as mistimed: desired sooner, mistimed: desired later, or unwanted were 20% (adjusted odds ratio [AOR] = 1.2; 95% confidence interval [CI]: 1.1–1.3), 30% (AOR = 1.3; 95% CI: 1.2–1.4), and 50% (AOR = 1.5; 95% CI: 1.3–1.7) more likely to experience symptoms of PPD, respectively, compared to women with desired pregnancies. Other factors found to be associated with experiencing symptoms of PPD were a gestational age of <27 weeks (AOR = 3.1; 95% CI: 2.5–4.0), having a previous history of depression (AOR = 1.8; 95% CI: 1.6–2.0), and being abused during or before pregnancy (AOR = 1.6; 95% CI: 1.4–2.0).We found that women with mistimed or unwanted pregnancies were more likely to experience symptoms of PPD. Our findings support the current US Preventive Services Task Force and American Academy of Pediatrics recommendations for an integrated approach to screening for depression, aiding in the maximization of intervention and early referral for women at risk for PPD.

Association between unintended births and risk of postpartum depression: Evidence from Ethiopia, India, Peru and Vietnam

“…A key strength of our study is that we have used a relatively large study population from countries, which are typically underrepresented in mental health research, and where the evidence on the association between unintended births and the risk of PPD is generally lacking. A majority of the studies on the adverse consequences of birth intention on PPD are based on Western countries (Cheng et al, 2009; Gauthreaux et al, 2017). Another uniqueness of this study is to control for social support received by mothers in the last 12 months preceding the survey.…”

“…Few studies from the developed world have reported positive association between unintended birth and PPD (Abbasi, Chuang, Dagher, Zhu, & Kjerulff, 2013; Brito, Alves, Ludermir, & Araújo, 2015; Gauthreaux et al, 2017; Mercier, Garrett, Thorp, & Siega-Riz, 2013). To date, in low and middle income countries, unintended births have been linked to multiple types of undesirable outcomes including but not limited to childhood mortality, high-risk pregnancy behavior (such as smoking, alcohol consumption during pregnancy), low birth weight, malnutrition and cognitive underdevelopment of children, poor antenatal care, and premature births (Dott, Rasmussen, Hogue, & Reefhuis, 2010; Han, Nava-Ocampo, & Koren, 2005; McCrory & McNally, 2013; Shah et al, 2011; Singh et al, 2012, 2013, 2017; Upadhyay & Srivastava, 2016).…”

Patterns of Symptoms of Perinatal Depression and Stress in Late Adolescent and Young Adult Mothers

“…Researchers have suggested that age is a risk factor for PPD, and that women in certain age groups are at higher risk than others (Gauthreaux et al, 2017). Adolescent mothers are at a greater risk of developing PPD because of multiple psychosocial issues, including poor social support (Verreault et al, 2014).…”

FATORES ASSOCIADOS À DEPRESSÃO PÓS-PARTO: Revisão Integrativa

“…Para Gauthreaux e colaboradores (2017), foram considerados estressores: ter um membro da família doente; separação ou divórcio do parceiro; falta de moradia; a entrevistada ou o cônjuge perderam o emprego; conflitos com o parceiro; cônjuge não desejava gravidez; ser incapaz de pagar as contas; estar em uma luta física; a entrevistada ou o parceiro foram para a prisão; alguém perto da entrevistada usa drogas ou álcool ou alguém perto da entrevistada morreu.…”