Abstract

ObjectiveThis study presents national estimates on symptoms consistent with postpartum anxiety (PPA) and postpartum depression (PPD) and the association between these conditions and possible risk and protective factors in women who gave birth in Canada.MethodsData were collected through the Survey on Maternal Health, a cross-sectional survey administered in Canada’s ten provinces between November 2018 and February 2019 among women who gave birth between January 1 and June 30, 2018. A total of 6558 respondents were included. Weighted prevalence estimates were calculated, and logistic regression was used to model the relationship between symptoms consistent with PPA, PPD, and potential risk factors.ResultsOverall, 13.8% of women had symptoms consistent with PPA, while the prevalence of having symptoms consistent with PPD was 17.9%. Results of the logistic regression models indicated that women who had a history of depression were 3.4 times (95% CI 2.7–4.2) more likely to experience symptoms consistent with PPA and 2.6 times more likely to experience symptoms consistent with PPD (95% CI 2.2–3.2) compared with those who did not. Women who reported good, fair, or poor physical health were 2.4 times more likely to experience symptoms consistent with PPD (95% CI 2.0–2.9) and 2.0 times more likely to experience symptoms consistent with PPA (95% CI 1.7–2.4) compared with those who reported very good or excellent health. Maternal marital status, other postpartum maternal support, and sense of community belonging were also significant.ConclusionThis study highlights that a history of depression and good, fair, or poor physical health are associated with an increased odds of symptoms consistent with PPA and PPD, while other maternal support and sense of community belonging are associated with a decreased odds of these conditions.

Highlights

  • Following childbirth, mothers may experience a range of emotions, including deep sadness or worrying, which can appear within days and last for years if left undiagnosed (Lanes et al 2011; Pawluski et al 2017)

  • postpartum depression (PPD) is often comorbid with postpartum anxiety (PPA) and symptomology is associated with greater severity (Pawluski et al 2017; Ramakrishna et al 2019)

  • Data were extracted from the Survey on Maternal Health (SMH), which was administered from November 29, 2018 to February 5, 2019

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Summary

Introduction

Mothers may experience a range of emotions, including deep sadness or worrying, which can appear within days and last for years if left undiagnosed (Lanes et al 2011; Pawluski et al 2017). Shoreya et al (2018) estimated the prevalence of PPD at 17% globally These conditions often remain undiagnosed and untreated in part because some of the associated symptoms, such as fatigue, weight fluctuation, or sleep disturbance, may be expected during the postpartum period (Iliadis et al 2018). In addition to these more generalized symptoms, PPA may be characterized by excessive worrying and obsessing, while PPD manifests as long-lasting and potentially severe feelings of sadness and hopelessness (Iliadis et al 2018). The strongest predictors of PPD include: depression during pregnancy, anxiety during pregnancy, experiencing stressful life events during pregnancy or the early puerperium, low levels of social support, and a previous history of depression (Robertson et al 2004)

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