Maternal and Child Health Journal

, Volume 16, Issue 4, pp 929–935 | Cite as

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

  • D. Yvette LaCoursiere
  • Kathryn P. Hirst
  • Elizabeth Barrett-Connor
Article

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.

Keywords

Abuse Pregnancy stressors Depression and postpartum depression 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • D. Yvette LaCoursiere
    • 1
  • Kathryn P. Hirst
    • 2
  • Elizabeth Barrett-Connor
    • 3
  1. 1.Division of General Obstetrics and Gynecology, Department of Reproductive MedicineUniversity of CaliforniaSan DiegoUSA
  2. 2.Department of Psychiatry and Department of Family and Preventive MedicineUniversity of CaliforniaSan DiegoUSA
  3. 3.Division of Epidemiology, Department of Family and Preventive MedicineUniversity of CaliforniaSan DiegoUSA

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