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Postpartum depression prevalence and risk factors among Indigenous, non-Indigenous and immigrant women in Canada

  • Nihaya DaoudEmail author
  • Kristen O’Brien
  • Patricia O’Campo
  • Sarah Harney
  • Evelyn Harney
  • Kerry Bebee
  • Cheryllee Bourgeois
  • Janet Smylie
Quantitative Research

Abstract

Objectives

The social position of different minority groups in contemporary societies suggests different risk factors for postpartum depression (PPD). In this study, we used two cut-offs of the Edinburgh Postpartum Depression Scale (EPDS) to examine prevalence and risk factors for PPD among mothers participating in the Canadian Maternity Experiences Survey (MES), and to compare Indigenous, Canadian-born non-Indigenous and immigrant mothers.

Methods

We used cross-sectional nationwide data from the 2006 MES (unweighted N = 6237, weighted N = 74,231) and conducted multivariate logistic regression models for EPDS ≥ 10 and EPDS ≥ 13 to explore risk factors for the total sample of mothers and in each study group.

Results

Prevalence (%, 95 % CI) of EPDS ≥ 10 and EPDS ≥ 13 was significantly higher among immigrant (12.2 %, 10.2–14.2 and 24.1 %, 21.5–26.7) and Indigenous (11.1 %, 7.5–14.7 and 21.2 %, 16.5–25.9) compared to Canadian-born non-Indigenous mothers (5.6 %, 4.9–6.3 and 12.9 %, 11.9–13.9). Multivariate analysis of the total sample showed similar risk factors for EPDS ≥ 10 and EPDS ≥ 13 (ethnicity, low education, ≥ low income cut-off, taking antidepressants, experiencing abuse, low social support). Stratification by study group revealed differing risk factors in each group for EPDS ≥ 10 and EPDS ≥ 13. Indigenous mothers had the most distinct risk factors, followed by immigrant mothers. Non-indigenous Canadian-born mothers had risk factors most similar to the total sample.

Conclusion

Differing prevalence and risk factors for PPD within and across study groups suggest that instead of a universal approach, tailored programs and services to prevent PPD in Indigenous, immigrant and non-Indigenous Canadian-born groups could better protect the mental health of Canadian mothers.

Keywords

Postpartum depression Edinburgh Postnatal Depression Scale (EPDS) Risk factors Canada Indigenous, immigrant, and non-Indigenous Canadian-born mothers 

Résumé

Objectifs

La position sociale de divers groupes minoritaires dans les sociétés contemporaines suggère des facteurs de risque différents pour la dépression postpartum. Notre étude emploie deux seuils de coupure dérivés de l’Échelle de dépression postnatale d’Edimbourg (EPDS) pour explorer la prévalence de la dépression postpartum et identifier facteurs de risque chez des mères participants à l’Enquête canadienne sur l’expérience de la maternité, et pour effectuer une comparaison entre trois groupes de mères : autochtones, non autochtones nées au Canada, et immigrantes.

Méthodes

Analyse de données de l’Enquête canadienne sur l’expérience de la maternité 2006 (N = 6237 non pondérées, N = 74,231 pondérées) et utilisation de modèles de régression logistique multivariés pour deux seuils de coupure (EPDS ≥ 10 et EPDS ≥ 13) pour explorer les facteurs de risque pour l’échantillon globale de mères, et pour chaqun des trois groupes.

Résultats

La prévalence (95 % IC) d’EPDS ≥ 10 et d’EPDS ≥ 13 était sensiblement plus haute chez les mères immigrantes (12,2 %, 10,2–14,2 et 24,1 %, 21,5–26,7) et autochtones (11,1 %, 7,5–14,7 et 21,2 %, 16,5–25,9) comparativement aux mères non autochtones nées au Canada (5,6 %, 4,9–6,3 et 12,9 %, 11,9–13,9). L’analyse multivariée de l’échantillon globale a démontré des facteurs de risque semblables pour EPDS ≥ 10 et EPDS ≥ 13 (ethnicité, faible niveau d’éducation, ≥ SFR, utilisation d’antidépresseurs, maltraitance, faible soutien). La stratification par groupe a révélé des facteurs de risques différents pour chaque groupe pour EPDS ≥ 10 et EPDS ≥ 13. Les mères autochtones avaient les facteurs de risque les plus distinctifs, suivi par les mères immigrantes. Les mères non autochtones nées au Canada avaient les facteurs de risque les plus semblables à ceux de l’échantillon globale.

Conclusion

Le taux de prévalence et les facteurs de risques variables entre les groupes sous étude indiquent qu’au lieu d’une politique universelle pour prévenir la dépression postpartum chez les mères autochtones, immigrantes, et non autochtones nées au Canada, des programmes et services sur mesure pourraient mieux protéger la santé mentale des mères canadiennes.

Mots-clés

Dépression postpartum L’Échelle de dépression postnatale d’Edimbourg Facteurs de risque Canada Mères autochtones, immigrantes, et non autochtones nées au Canada 

Notes

Acknowledgements

We thank the Research Data Centre (RDC) team of the University of Toronto (UoT).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Canadian Public Health Association 2019

Authors and Affiliations

  1. 1.Department of Public Health, Faculty of Health SciencesBen-Gurion University of the NegevBeer ShevaIsrael
  2. 2.Centre for Urban Health SolutionsSt. Michael’s HospitalTorontoCanada
  3. 3.Dalla Lana School of Public HealthTorontoCanada
  4. 4.Native Women’s Association of Canada (NWAC)OttawaCanada
  5. 5.National Aboriginal Council of Midwives (NACM)MontréalCanada

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