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Prenatal health behaviors and postpartum depression: is there an association?

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Abstract

Postpartum depression is a prevalent mental disorder; however, scarce research has examined its association with prenatal health behaviors. This study investigated the associations of cigarette smoking, caffeine intake, and vitamin intake during pregnancy with postpartum depressive symptoms at 8 weeks after childbirth. Using a prospective cohort study design, participants were recruited from the postpartum floor at a hospital for women and newborns located in a northeastern city, from 2005 through 2008. Eligible women who were at least 18 years old and spoke English were interviewed in person while hospitalized for childbirth (N = 662). A follow-up home interview was conducted at 8 weeks postpartum with a 79% response rate (N = 526). Hierarchical regression analyses showed that smoking cigarettes anytime during pregnancy and not taking prenatal vitamins in the first trimester were significantly associated with worse depressive symptoms (Edinburgh Postnatal Depression Scale). Moreover, having a colicky infant, an infant that refuses feedings, being stressed out by parental responsibility, and having difficulty balancing responsibilities were stressors associated with worse depressive symptoms. Primary health care providers should consider evaluating women for risk of postpartum depression during their first prenatal visit, identifying prenatal health behaviors such as smoking and taking prenatal vitamins.

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Notes

  1. Hierarchical regression builds successive linear regression models, where each model adds more predictors and the change in R 2 is calculated. This type of regression was used because the literature is scarce on the relationships examined.

  2. Due to the potential problem of multicollinearity, we could not run a regression analysis that included whether or not the woman smoked during pregnancy in addition to the number of cigarettes smoked. However, we ran an alternative regression that included the maximum number of cigarettes smoked at each trimester of pregnancy but none of the variables had a significant association with postpartum depressive symptoms (results available upon request).

  3. We conducted an alternative regression analysis utilizing dose of caffeine instead of whether the women drank caffeine during pregnancy, and this variable did not show a significant association with postpartum depressive symptoms either. We constructed this variable by categorizing women into those who did not drink caffeine at all, drank one source of caffeine, drank two sources of caffeine, or drank three sources of caffeine. Sources of caffeine included soda, coffee, and tea (results available upon request).

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Funding

This publication was supported by Grant #R40MC03600-01-00 from the Maternal and Child Health Bureau, Department of Health and Human Services. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Maternal and Child Health Bureau.

Conflict of interest statement

The authors report no conflict of interest with regards to this manuscript

Author information

Authors and Affiliations

  1. Department of Health Services Administration, School of Public Health, University of Maryland, 3310B School of Public Health Building, College Park, MD, 20742, USA

    Rada K. Dagher

  2. Maternal and Child Health Program, Department of Family Science, University of Maryland, College Park, MD, USA

    Edmond D. Shenassa

  3. Department of Epidemiology, Public Health Program, Brown University, Providence, RI, USA

    Edmond D. Shenassa

Authors
  1. Rada K. Dagher
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  2. Edmond D. Shenassa
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Correspondence to Rada K. Dagher.

Additional information

Prior presentation of this paper is in a study entitled “Prenatal health behaviors and postpartum depression: Is there an association?” by R. Dagher with E. Shenassa (poster presentation), Academy Health Annual Research Meeting, Boston, MA, June 27–29, 2010 (also presented at the Gender and Health Interest Group session, June 26, 2010).

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Dagher, R.K., Shenassa, E.D. Prenatal health behaviors and postpartum depression: is there an association?. Arch Womens Ment Health 15, 31–37 (2012). https://doi.org/10.1007/s00737-011-0252-0

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