Prevalence and Associated Risk Factors of Postpartum Depression among Mothers in Pennsylvania, United States: An Analysis of the Pregnancy Risk Assessment Monitoring System (PRAMS) Data, 2012-2015

Abstract

Background: Postpartum depression (PPD) is the most common morbidity among new mothers. With an estimated 140,000 resident births annually in the state of Pennsylvania, United States, no publication is available about the prevalence and risk factors associated with PPD specifically for Pennsylvania. This study aims to estimate the self-reported prevalence and risk factors associated with PPD. Methods: Weighted Pregnancy Risk Assessment Monitoring System (PRAMS) surveillance data of 4,022 Pennsylvania mothers with live birth(s) during 2012-2015 were analyzed. Descriptive statistics were used for mothers’ characteristics. Between-group differences were evaluated using the Chi-square test. Risk factors associated with PPD were analyzed by logistic regression models. All analyses were performed using Stata version 13 (STATA Corp., College Station, TX), taking into account the complex survey design, and P-values <0.05 (2-tailed) were considered statistically significant. Results: Of the 4,022 mothers, the overall prevalence of PPD was 12.1% (515 mothers); the prevalence was 12.4% (108) in 2012, spiked to 14.8% (156) in 2013, then significantly declined to 10.9% (127) in 2014 and 10.1% (124) in 2015 (p=0.03). In a multivariable logistic model, significant risk factors included depression before pregnancy (adjusted odds ratio [aOR]: 3.7, 95% CI: 2.3-6.0), abuse before or during pregnancy (aOR: 3.5, 95% CI: 1.6-7.3), the mother’s job loss (aOR: 2.1, 95% CI: 1.3-3.4), extended time away from husband/partner due to military deployment or work-related travel (aOR: 2.3, 95% CI: 1.1-4.5), a husband/partner not wanting the pregnancy (aOR: 1.7, 95% CI: 1.1-2.9), and arguing more than usual with a husband/partner (aOR: 1.6, 95% CI: 1.4-2.4). Conclusion and Implication for Translation: PPD is relatively common in Pennsylvania; however, the prevalence declined significantly during the study period. Depression before pregnancy, abuse before or during pregnancy, job loss, extended time away from husband/partner due to military deployment or workrelated travel, husband/partner not wanting the pregnancy, or arguing more than usual with a husband/ partner increased the odds of experiencing PPD. Further studies should be conducted on approaches to prevent PPD among new mothers.