260339 Relationship between the maternal Stress to Resiliency Ratio (SRR) during pregnancy and postpartum depression (PPD): Findings from the 2007 Los Angeles Mommy and Baby (LAMB) study

Wednesday, October 31, 2012 : 12:40 PM - 12:55 PM

Fathima Wakeel, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Lauren E. Wisk, BS , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Rebekah Gee, MD, MPH, MSHPR , School of Public Health, Louisiana State University, New Orleans, LA
Shin Margaret Chao, PhD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Whitney P. Witt, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
     
OBJECTIVE: To examine the association between the maternal Stress to Resiliency Ratio (SRR) and postpartum depression (PPD).

METHODS: We used data from the Los Angeles Mommy and Baby (LAMB) study, a mailed survey based on a multistage clustered design with telephone follow-up for non-respondents. Analyses were based on the responses of 706 women who had a live birth in LA County in 2007. The maternal resiliency index comprised personal resources (self-esteem and mastery) and social resources (partner, social network, and neighborhood support) that women drew upon during pregnancy. The stress index consisted of severe life events and perceived stress during pregnancy. The stress index was divided by the resiliency index to create the raw SRR, which was then transformed into a natural log SRR. An SRR>0 signified greater stress relative to resiliency. PPD was measured using a 9-item Center for Epidemiological Studies Depression Scale (range of 0-27). Logistic regression analyses were used to assess the association between the SRR and PPD.

RESULTS: 38.2% of respondents were categorized as suffering PPD (cutoff point=7). The maternal SRR was significantly associated with having PPD (AOR=25.3, 95% CI=11.9, 53.5), even after controlling for prenatal depression, sociodemographic factors, parity, pregnancy complications, and having a low birthweight or preterm baby.

CONCLUSIONS: Experiencing greater stress than resiliency during pregnancy is significantly associated with the risk of PPD. Interventions during the preconception and prenatal periods are warranted to increase resiliency among high-stress women in order to improve postpartum mental health and long-term maternal and child health outcomes.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
1) Explain the components of the maternal stress to resiliency ratio; 2) Describe the relationship between the maternal stress to resiliency ratio and the risk of postpartum depression; 3) Discuss programmatic and policy implications of our findings.

Keywords: Depression, Stress

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been extensively working with the LAMB study since 2006, and I have presented various findings using the LAMB study data since October 2008. I am also the first author on work regarding the development the maternal stress-to-resiliency ratio (SRR) and its relationships with a number of prenatal, obstetric, and postpartum outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5195.0: Mental Health in the Prenatal and Postpartum Periods