Abstract
Background:In the United States, there is a disparity in knowledge of nationwide depression prevalence, the antidepressant use and the antidepressant responses during perinatal/postpartum periods.Objective:This study investigated the predicting factors of depression, antidepressant use and positive antidepressant response during the perinatal/postpartum periods.Method:The 2007-2012 National Health and Nutrition Examination Surveys (NHANES) were combined to identify adult pregnant women, those within the 18-month postpartum period (n=492) and their depression statuses via demographics, health care accessibility, antidepressant use and illicit drug use information. The characteristics of different study groups were compared (depression versus no-depression groups, antidepressant users versus non-antidepressant users, and antidepressant responders versus antidepressant non-responders). Multivariable logistic regression analysis was used to predict factors of perinatal depression (PND)/ postpartum depression (PPD), antidepressant use and antidepressant positive response in PND/PPD.Results:PND/PPD individuals had higher rates of mental health visits. No predicting factor for developing PND/PPD was shown. Antidepressant users were significantly older with insurance and recent health checkups/ mental visits. Being below the poverty level and having some health care accessibility are predictors for being on antidepressants. Recent non-illicit drug use is a predictor for PND/PPD symptom improvement while on antidepressants.Conclusion:The group of those with social-economic disadvantages was more likely to be on antidepressants for PND/PPD. Illicit drug users were less likely to show improvement with antidepressants. The safety and efficacy of antidepressant use during this period is controversial. More studies need to focus on the barriers involving antidepressant treatments, the safety and outcomes of antidepressants for PND/PPD management.
Highlights
In the United States (US), depression places a major disease burden on those who are affected, their families and society
The study design is illustrated in (Fig. 1). When it came to determine the differences between the perinatal depression (PND)/postpartum depression (PPD) and no-depression groups in the analysis, a total of 492 respondents met the study criteria during the study period, with 216 participants (43.90%) meeting the depression criteria
No statistically significant difference was found in average age, ratio of family income to poverty, educational level, availability of partners, availability of insurance, availability of prescription coverage, accessibility of health care services and illicit drug use between the group with and without depression
Summary
In the United States (US), depression places a major disease burden on those who are affected, their families and society. That burden has been especially reported during the perinatal and postpartum periods, with a prevalence ranging from 10% to 19.2% [1 - 5]. Studies of low-income and teenager mothers have reported a higher rate of depression symptoms at 40%-60% [6]. Due to help-seeking barriers, such as social and cultural stigma [7, 8], the real prevalence of perinatal depression (PND) and postpartum depression (PPD) might have been higher. The proper management of PND and PPD is essential during this period. In the United States, there is a disparity in knowledge of nationwide depression prevalence, the antidepressant use and the antidepressant responses during perinatal/postpartum periods
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