P063Association between postpartum contraceptive use and postpartum depression at 12 months

Abstract

<h3>Objectives</h3> To evaluate whether progestin-only (POC) or combined hormonal contraception (CHC) users are more likely to have a positive 12-month postpartum depression screen compared with those using non-hormonal (NH) or no contraception. <h3>Methods</h3> We conducted a secondary analysis of a prospective cohort of pregnant patients followed for one year postpartum. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) in the second or third trimester and 12 months post-delivery. We examined differences in participant characteristics, mental health history, and 12-month EPDS scores between method groups: POC, CHC, and NH contraception or no contraception. We used multivariable logistic regression to assess factors associated with positive depression screen (EPDS ≥10) at 12 months, adjusting for differences between groups and contraceptive discontinuation. <h3>Results</h3> Of the 227 participants in this analysis, 47% chose POC, 19% chose CHC, and 34% chose NH or no contraception. The overall incidence of positive depression screen at 12 months was 21.2% and did not differ by contraceptive method: POC, 18.7%; CHC, 28.6%; and no method/NH 20.5% (p=0.39). After adjusting for confounders, contraceptive method remained unassociated with depression (POC adjusted OR (aOR), 0.59; 95% CI, 0.28–1.40; CHC aOR, 1.38; 95% CI, 0.53–3.58). However, last antenatal EPDS score ≥10 (aOR, 5.88; 95% CI, 2.5413.59) and postpartum mental health referral (aOR, 3.81; 95% CI, 1.94–7.49) were significantly associated. <h3>Conclusions</h3> In this cohort, the incidence of postpartum depression was greater than 20%. Individuals initiating hormonal contraception in the first 12 months postpartum were no more likely to have a positive depression screen at 12 months postpartum.