Abstract
BackgroundPostpartum depression was associated with maternal suffering and diminished functioning, increased risk of marital conflict as well as adverse child outcomes. Perceived social support during pregnancy was associated with postpartum depression among women. However, its causal relationship remains unclear. Therefore, we prospectively evaluate the association between perceived social support during early pregnancy and postpartum depressive symptoms.MethodsWe prospectively examined whether perceived social support during early pregnancy affected depressive symptoms at 6 weeks postpartum in a cohort of 3310 women. Perceived social support and postpartum depression were assessed by ENRICHD Social Support Instrument (ESSI) and the postpartum Edinburgh Postpartum Depression Scale (EPDS), respectively. Prevalence of postpartum depressive symptoms was 11.4% (EPDS cutoff≥10). As a test of heterogeneity of association in subpopulations, logistic regression models were performed to analyze the association between social support and postpartum depressive symptoms in strata which were defined by the potential confounder candidates. After multiple imputation, multivariable logistic regression was performed to assess the effect of social support on postpartum symptoms in individual items and total score. Two models were built. Model I adjusted for the variables associated with social support or postpartum depression and changed the association estimates by ≥10%. Model II adjusted for all variables that may be related to social support or postpartum depression.ResultsSignificant associations between low perceived social support and postpartum depressive symptoms was found(Model I odds ratio: 1.63, 95% confidence interval: 1.15, 2.30; Model II odds ratio: 1.77, 95% confidence interval: 1.24–2.52). Stratified analyses showed that there was little evidence of heterogeneity of association in subpopulations by basic characteristics of participants.ConclusionsThese findings suggest that early intervention may be able to help protect against depression symptoms at 6 weeks postpartum.
Highlights
Postpartum depression was associated with maternal suffering and diminished functioning, increased risk of marital conflict as well as adverse child outcomes
A higher proportion of women with postpartum depressive symptoms were from a population who felt bad about the economic status, the health level or sleep quality (Table 2)
Women with depressive symptoms at 6 weeks postpartum were more likely to receive lower social support and to have alcohol-use in addition to having lower economic status, health level or sleep quality according to self-assessment
Summary
Postpartum depression was associated with maternal suffering and diminished functioning, increased risk of marital conflict as well as adverse child outcomes. Perceived social support during pregnancy was associated with postpartum depression among women. We prospectively evaluate the association between perceived social support during early pregnancy and postpartum depressive symptoms. It is related to maternal suffering and diminished functioning [6], increased risks of marital conflict in addition to adverse child outcomes including impaired behavioral, emotional, cognitive development and physical health in the children [7, 8]. Maternal suicide and infanticide may be extreme outcomes of PPD [9, 10] It may naturally recover, women with postpartum depression may still suffer from depression beyond the first year after delivery, even after 2 years [11]. It is important to identify the potential protective or risk factors for postpartum depression in Chinese women
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