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Depression and Pregnancy Stressors Affect the Association Between Abuse and Postpartum Depression

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Abstract

To determine how psychosocial factors affect the association between a history of abuse and postpartum depression (PPD). Women at four urban hospitals in Utah were enrolled ≤48 h of delivering a live-born infant. At enrollment, pregravid history of physical or sexual abuse was obtained via self-report. Psychosocial covariates such as pregnancy stressors and depression were also collected. Pregnancy stressors were categorized using “stressor” questions from the Pregnancy Risk Assessment Monitoring System. The primary outcome measure, a pre-specified Edinburgh Postnatal Depression Scale score of ≥12 was obtained 6–8 weeks postpartum. Among the 1,038 women studied, psychosocial risk factors were common: abuse history 11.7%, pregnancy stressors–financial 49.1%, emotional 35.0%, partner-associated 19.8%, and traumatic 10.3% and depression history 16.7%. While abuse was associated with a +PPD screen in a preliminary model [aOR 2.05 (1.28, 3.26)], adding psychosocial covariates reduced the unadjusted association of abuse and PPD [aOR 1.12 (0.66, 1.91)]. After adjustment, PPD was associated with depression history [aOR 2.85 (1.90, 4.28)], prepregnancy BMI [aOR 1.04 (1.01, 1.07)] multiple stressors [3 categories aOR 4.35 (2.00, 9.46)]; 4 categories [aOR 6.36 (2.07, 19.49)] and sum of stressors * history of abuse [aOR 1.50 (0.92, 2.46)]. Interestingly only women with a moderate number of stressors were sensitive to an abuse history. Abuse and pregnancy stressors are common and interact to influence the likelihood of screening positive for PPD.

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Acknowledgments

Funding sources that support this research include the NIH RO3 HD048865 and NIH Women’s Reproductive Health Research Program K12 HD001259.

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Authors and Affiliations

  1. Division of General Obstetrics and Gynecology, Department of Reproductive Medicine, University of California, 200 West Arbor Dr., #8433, San Diego, CA, 92103, USA

    D. Yvette LaCoursiere

  2. Department of Psychiatry and Department of Family and Preventive Medicine, University of California, San Diego, CA, USA

    Kathryn P. Hirst

  3. Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, CA, USA

    Elizabeth Barrett-Connor

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  1. D. Yvette LaCoursiere
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  2. Kathryn P. Hirst
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  3. Elizabeth Barrett-Connor
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Correspondence to D. Yvette LaCoursiere.

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Yvette LaCoursiere, D., Hirst, K.P. & Barrett-Connor, E. Depression and Pregnancy Stressors Affect the Association Between Abuse and Postpartum Depression. Matern Child Health J 16, 929–935 (2012). https://doi.org/10.1007/s10995-011-0816-7

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  • DOI: https://doi.org/10.1007/s10995-011-0816-7

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