Objectives: This study examined the relationship of social support, and of social networks, to symptoms of depression in a multiethnic sample of women having recently given birth. Methods: Women at community health centers in a Northeastern city were randomly sampled from groups stratified by race/ethnicity (African American, Hispanic, and White) and postpartum interval. Mother's score on the Center for Epidemiologic Studies of Depression Scale (CES-D) was the dependent variable. Main independent variables included the Medical Outcomes Study (MOS) Social Support Survey and a social network item. Univariate statistics assessed the relationship between CES-D score and each of the independent variables. Multivariate linear regression models included core sociodemographic variables alone, the core model with each of the social support and social network variables added separately, and all variables together. We evaluated interactions between race and social support, race and social networks, and social support and social networks. Results: The multivariate models with MOS Social Support and core variables indicated that each 10-point increase in the MOS Social Support Survey was related to a 2.1-unit lower score on the CES-D (95% CI −2.4, −1.7). The inclusion of the social network variable into the core model showed that having two or more friends or family members available was associated with a 13.6-point lower mean score on the CES-D (95% CI −17.5, −9.6), compared to women reporting none or only one available person. Conclusions: Both social support and social networks were statistically significant and independently related to depressive symptomatology.
postpartum depression social support social networks multiethnic sample.
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This study was supported by the Maternal and Child Health Bureau (MCJ-259356). The authors express their appreciation to Dr. Marie McCormick, whose expertise guided this project from its inception. We also gratefully acknowledge the contributions of Rachel Levine and Cary Perry, who served as project coordinators and research associates, and Peter Gaccione for his contribution to data analysis.
Ballard CG, Davis R, Cullen PC, Mohan RN, Dean C. Prevalence of postnatal psychiatric morbidity in mothers and fathers. Br J Psychiatry 1994;164:782–8.PubMedCrossRefGoogle Scholar
Najman JM, Andersen MJ, Bor W, O’Callaghan MJ, Williams GM. Postnatal depression-myth and reality: Maternal depression before and after the birth of a child. Soc Psychiatry Psychiatr Epidemiol 2000;35:19–27.CrossRefPubMedGoogle Scholar
Diagnostic and statistical manual of disorders. 4th ed. Washington, DC: American Psychiatric Association, 2000.Google Scholar
Dennis CL, Janssen PA, Singer J. Identifying women at-risk for postpartum depression in the immediate postpartum period. Acta Psychiatr Scand 2004;110:338–46.CrossRefPubMedGoogle Scholar
Seimyr L, Edhborg M, Lundh W, Sjögren B. In the shadow of maternal depressed mood: Experiences of parenthood during the first year after childbirth. J Psychosom Obstet Gynaecol 2004;25:23–34.CrossRefPubMedGoogle Scholar
Gale S, Harlow BL. Postpartum mood disorders: A review of clinical and epidemiological factors. J Psychosom Obstet Gynaecol 2003;24:257–66.PubMedCrossRefGoogle Scholar
Garvey MJ, Tuason VB, Lumry AE, Hoffmann NG. Occurrence of depression in the postpartum state. J Affect Disord 1983;5:97–101.CrossRefPubMedGoogle Scholar
Lovejoy MC, Graczyk PA, O’Hare E, Neuman G. Maternal depression and parenting behavior: A meta-analytic review. Clin Psychol Rev 2000;20:561–92.CrossRefPubMedGoogle Scholar
Martins C, Gaffan EA. Effects of early maternal depression on patterns of infant–mother attachment: A meta-analytic investigation. J Child Psychol Psychiatry 2000;41:737–46.CrossRefPubMedGoogle Scholar
Petterson SM, Albers AB. Effects of poverty and maternal depression on early child development. Child Dev 2001;72:1794–1813.CrossRefPubMedGoogle Scholar
Ritter C, Hobfoll SE, Lavin J, Cameron RP, Hulsizer MR. Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women. Health Psychol 2000;19:576–85.CrossRefPubMedGoogle Scholar
Seeman TE, Berkman LF, Kohout F, Lacroix A, Glynn R, Blazer D. Intercommunity variations in the association between social ties and mortality in the elderly. A comparative analysis of three communities. Ann Epidemiol 1993;3:325–35.PubMedCrossRefGoogle Scholar
Stewart AL, Ware JE (Eds.). Measuring functioning and well-being: The Medical Outcomes Study approach. Durham, NC: Duke University Press, 1992.Google Scholar
Kreiger N, Chen J. Socio-demographic and cultural module for the breast cancer core questionnaire. Boston, MA: Harvard School of Public Health, 1997.Google Scholar
Séguin L, Potvin L, St-Denis M, Loiselle J. Depressive symptoms in the late postpartum among low socioeconomic status women. Birth 1999;26:157–63.CrossRefPubMedGoogle Scholar
Panzarine S, Slater E, Sharps P. Coping, social support, and depressive symptoms in adolescent mothers. J Adolesc Health 1995;17:113–9.CrossRefPubMedGoogle Scholar
Brugha TS, Sharp HM, Cooper SA, Weisender C, Britto D, Shinkwin R, Sherrif T, Kirwan PH. The Leicester 500 project. Social support and the development of postnatal depressive symptoms, a prospective cohort survey. Psychol Med 1998;28:63–79.CrossRefPubMedGoogle Scholar
Beeghly M, Olson KL, Weinberg MK, Pierre SC, Downey N, Tronick EZ. Prevalence, stability, and socio-demographic correlates of depressive symptoms in black mothers during the first 18 months postpartum. Matern Child Health J 2003;7:157–68.CrossRefPubMedGoogle Scholar
Lupien SJ, King S, Meaney MJ, McEwen BS. Can poverty get under your skin? Basal cortisol levels and cognitive function in children from low and high socioeconomic status. Dev Psychopathol 2001;13:653–76.CrossRefPubMedGoogle Scholar
Gurel S, Gurel H. The evaluation of determinants of early postpartum low mood: The importance of parity and inter-pregnancy interval. Eur J Obstet Gynecol Reprod Biol 2000;91:21–4.CrossRefPubMedGoogle Scholar
Szalacha LA, Erkut S, Garcia Coll C, Alarcon O, Fields JP, Ceder I. Discrimination and Puerto Rican children's and adolescents’ mental health. Cult Divers Ethnic Minor Psychol 2003;9:141–55.CrossRefGoogle Scholar
Ren XS, Amick BC, Williams DR. Racial/ethnic disparities in health: The interplay between discrimination and socioeconomic status. Ethn Dis 1999;9:151–65.PubMedGoogle Scholar
Pavalko EK, Mossakowski KN, Hamilton VJ. Does perceived discrimination affect health? Longitudinal relationships between work discrimination and women's physical and emotional health. J Health Soc Behav 2003;44(1):18–33.PubMedCrossRefGoogle Scholar