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Influence of health information levels on postpartum depression

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An Erratum to this article was published on 01 October 2013

Abstract

While extensive research has been conducted on postpartum depression (PPD), the majority has been focused on psychological risk factors and treatments. There is limited research on the explicit relationship between the degree to which individuals are informed about relevant prenatal and postnatal health topics and whether this level of knowledge influences psychological outcome. This study assesses health information levels of new mothers and their influence on PPD as measured by Edinburgh Postnatal Depression Scale (EPDS) scores. Data from the 2006 Maternity Experiences Survey developed by the Canadian Perinatal Surveillance System (N = 6,421) were used. The study population included mothers ≥15 years of age at the time of the birth, who had a singleton live birth in Canada during a 3-month period preceding the 2006 Census and who lived with their infants at the time of the survey. Pre- and postnatal health information components were measured using latent variables constructed by structural equation modeling. EPDS score was added to the model, adjusting for known covariates to assess the effects of information levels on EPDS score. Pre- and postnatal health information levels are associated with decreased EPDS scores. More specifically, information on topics such as postnatal concerns and negative feelings was associated with the largest decrease in score for primiparous and multiparous women, respectively (p < 0.0001 for both). The pre-established predictors of PPD were confirmed for both samples, with life stress associated with the largest change in EPDS score for both samples (p < 0.0001 for both). This study demonstrates a distinct role for pre- and postnatal health information in influencing EPDS scores, supplementing previous literature. Primiparous and multiparous women benefited from different information content, with information on postnatal concerns had the largest effect on the primiparous group while information on negative feelings had the largest effect on the multiparous group. Therefore, information provision should be tailored to these two groups.

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References

  • Alder NE, Newman K (2002) Socioeconomic disparities in health: pathways and policies. Health Aff (Project Hope) 21(2):60

    Article  Google Scholar 

  • American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, D.C

    Google Scholar 

  • Beck CT (1998) The effects of postpartum depression on child-development: a meta-analysis. Arch Psychiatr Nurs 12(1):12–20

    Article  PubMed  CAS  Google Scholar 

  • Beck CT (2001) Predictors of postpartum depression: an update. Nurs Res 50(5):275–285

    Article  PubMed  CAS  Google Scholar 

  • Benzeval M, Judge K (2001) Income and health: the time dimension. Soc Sci Med 52(9):1371–1390

    Article  PubMed  CAS  Google Scholar 

  • Bollen KA, Paxton P (1998) Interactions of latent variables in structural equation models. Struct Equ Model 5(3):267–293

    Article  Google Scholar 

  • Braveman P, Marchi K, Egerter S, Kim S, Metzier M, Stancil T et al (2010) Poverty, near-poverty, and hardship around the time of pregnancy. Matern Child Health J 14(1):20–35

    Article  PubMed  Google Scholar 

  • Brugha T, Sharp H, Cooper S, Weisender C, Britto D, Shinkwin R et al (1998) The Leicester 500 project: social support and the development of postnatal depressive symptoms, a prospective cohort survey. Psychol Med 28(1):63–79

    Article  PubMed  CAS  Google Scholar 

  • Chalmers B, Dzakpasu S, Heaman M, Kaczorowski J, Maternity Experiences Study Group of the Canadian Perinatal Surveillance System (2008) The Canadian Maternity Experiences Survey: an overview of findings. J Obstet Gynaecol Canada 30(3):217–228

    Google Scholar 

  • Clark LA, Watson D (1991) Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. J Abnorm Psychol 100(3):316–336

    Article  PubMed  CAS  Google Scholar 

  • Collins JW, Wall SN, David RJ (1997) Adequacy of prenatal care utilization, maternal ethnicity, and infant birthweight in Chicago. J National Med Assoc 89(3):198–203

    Google Scholar 

  • Collins NL, Dunkel-Schetter C, Lobel M, Scrimshaw SCM (1993) Social support in pregnancy: psychosocial correlates of birth outcomes and postpartum depression. J Personal Soc Psychol 65(6):1243–1258

    Article  CAS  Google Scholar 

  • Costello AB, Osborne JW (2005) Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval 10(7):1

    Google Scholar 

  • Cox JL, Murray D, Chapman G (1993) A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry 163:27–31

    Article  PubMed  CAS  Google Scholar 

  • Cox JL, Chapman G, Murray D, Jones P (1996) Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women. J Affect Disord 39(3):185

    Article  PubMed  CAS  Google Scholar 

  • Deaton A (2002) Policy implications of the gradient of health and wealth. Health Aff (Project Hope) 21(2):13

    Article  Google Scholar 

  • Dennis CL, Janssen PA, Singer J (2004) Identifying women at-risk for postpartum depression in the immediate postpartum period. Acta Psychiatr Scand 110(5):338–346

    Article  PubMed  Google Scholar 

  • DiPietro JA, Costigan KA, Sipsma HL (2008) Continuity in self-report measures of maternal anxiety, stress, and depressive symptoms from pregnancy through two years postpartum. J Psychosom Obstet Gynecol 29(2):115–124

    Article  Google Scholar 

  • Dzakpasu S, Kaczorowski J, Chalmers B, Heaman M, Duggan J, Neusy E (2008) The Canadian maternity experiences survey: design and methods. J Obstet Gynaecol Canada 30(3):207

    Google Scholar 

  • Eiser C, Eiser JR (1985) Health education needs of primigravidae. Child Care Health Dev 11(2):53–60

    Article  PubMed  CAS  Google Scholar 

  • Essex HN, Pickett E (2008) Mothers without companionship during childbirth: an analysis within the millennium cohort study. Birth 35(4):266–276

    Article  PubMed  Google Scholar 

  • Forman DN, Videbech P, Hedegaard M, Salvig JD, Secher NJ (2000) Postpartum depression: identification of women at risk. British J Obstet Gynecol 107(10):1210–1217

    Article  Google Scholar 

  • Heh SS, Fu YY (2003) Effectiveness of informational support in reducing the severity of postnatal depression in Taiwan. J Adv Nurs 42(1):30–36

    Article  PubMed  Google Scholar 

  • Heron J, O’Conner TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80(1):65–73

    Article  PubMed  Google Scholar 

  • Himmelhoch J, Levine J, Gershon S (2001) Historical overview of the relationship between anxiety disorders and affective disorders. Depression and Anxiety 14(2):53–66

    Article  PubMed  CAS  Google Scholar 

  • Johnstone S, Boyce P, Hickey A, Morris-Yates A, Harris M (2001) Obstetric risk factors for postnatal depression in community samples. Australian and New Zealand J Psychiatry 35(1):69–74

    Article  CAS  Google Scholar 

  • Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C, Sydsjo G (2002) Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol 99(2):223–228

    Article  PubMed  Google Scholar 

  • Kaplan D (1994) Estimator conditioning diagnostics for covariance structure models. Sociol Methods Res 23(2):200–229

    Article  Google Scholar 

  • Lundrigan DE (1991) Information seeking of pregnant women: a grounded theory approach. Unpublished master of nursing school of nursing. Memorial University of Newfoundland, Newfoundland

    Google Scholar 

  • Marnot M (2002) The influence of income on health: views from an epidemiologist. Health Aff (Project Hope) 21(2):31–46

    Article  Google Scholar 

  • National Institute of Health (2005) Theory at a glance: A guide for health promotion practice. Retrieved May 15, 2013 from http://www.cancer.gov/cancertopics/cancerlibrary/theory.pdf

  • Newton RW, Hunt LP (1984) Psychosocial stress in pregnancy and its relation to low birthweight. British Med J 288:1191

    Article  CAS  Google Scholar 

  • Niven CA, Murphey-Black T (2000) Memory for labor pain: a review of the literature. Birth 27(4):244–253

    Article  PubMed  CAS  Google Scholar 

  • O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 8(1):37–54

    Article  Google Scholar 

  • Pop VJ, Essed GG, de Geus CA, van Som MM, Kromproe IH (1993) Prevalence of PPD or is it postpartum depression? Acta Obstet Gynecol Scand 72(5):354–358

    Article  PubMed  CAS  Google Scholar 

  • R Development Core Team (2011). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org/

  • Robertson E, Grace S, Wallington T, Stewart D (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26(4):289–295

    Article  PubMed  Google Scholar 

  • Rosenfield AI (2007) Barriers to postpartum depression screening, diagnosis and treatment. In: Rosenfield AI (ed) New research on postpartum depression. Nova Science Publishers, Inc., New York, p 59

    Google Scholar 

  • Ross LE, Sellers EM, Evans SEG, Romach MK (2004) Mood changes during pregnancy and the postpartum period: development of a biopsychosocial model. Acta Psychiatr Scand 109(6):457–466

    Article  PubMed  CAS  Google Scholar 

  • Schumacker RE, Lomax RG (2010) A beginner’s guide to structural equation modeling, 3rd edn. Routledge, New York

    Google Scholar 

  • Seguin L, Therrien R, Champagne F, Larouche D (1999) The components of women’s satisfaction with maternity care. Birth 16(3):109–113

    Article  Google Scholar 

  • Shieh C, McDaniel A, Ke I (2009) Information-seeking and its predictor in low-income pregnant women. J Midwifery Women’s Health 54(5):364–372

    Article  Google Scholar 

  • Somers-Smith MJ (1999) A place for the partner? Expectations and experiences of support during childbirth. Midwifery 15(2):101–108

    Article  PubMed  CAS  Google Scholar 

  • Statistics Canada. (2009a). Data quality, concepts and methodology: Definitions. Retrieved March 10, 2011, from http://www.statcan.gc.ca/pub/84f0210x/2007000/technote-notetech1-eng.htm

  • Statistics Canada. (2009b). Low income cut-offs for 2008 and low income measures for 2007 Retrieved March 15, 2011, from http://www.statcan.gc.ca/pub/75f0002m/75f0002m2009002-eng.pdf

  • Swendsen J, Mazure CM (2000) Life stress as a risk factor for postpartum depression: current research and methodological issues. Am Psychol Assoc 7(1):17–31

    Google Scholar 

  • Tomeo CA, Rich-Edwards JW, Michels KB, Berkey CS, Hunter DJ, Frazier AL (1999) Reproducibility and validity of maternal recall of pregnancy-related events. Epidemiology 10(6):774–777

    Article  PubMed  CAS  Google Scholar 

  • Waldenstrom U (2003) Women’s memory of childbirth at two months and one year after the birth. Birth 30(4):248–254

    Article  PubMed  Google Scholar 

  • Watson JP, Elliott SA, Rugg AJ, Brough DI (1984) Psychiatric disorder in pregnancy and the first postnatal year. Br J Psychiatry 144:453–462

    Article  PubMed  CAS  Google Scholar 

  • Webster J, Linnane JWJ, Dibley LM, Hinson JK, Starrenburg SE, Roberts JA (2000) Measuring social support during pregnancy: can it be simple and meaningful? Birth 27(2):97–101

    Article  PubMed  CAS  Google Scholar 

  • Xie RH, Guoping H, Koszycki D, Walker M, Wen SW (2009) Prenatal social support, postnatal social support and postpartum depression. Ann Epidemiol 19(9):637–643

    Article  PubMed  Google Scholar 

  • Youash S, Campbell MK, Avison W, Penava D, Xie B (2012) Examining the pathways of pre- and postnatal health information. Canadian J Public Health 103(4):314–319

    Google Scholar 

Download references

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Correspondence to Sabrina Youash.

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Youash, S., Campbell, K., Avison, W. et al. Influence of health information levels on postpartum depression. Arch Womens Ment Health 16, 489–498 (2013). https://doi.org/10.1007/s00737-013-0368-5

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  • DOI: https://doi.org/10.1007/s00737-013-0368-5

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