Are Pre-conception and Prenatal Health Behaviors and Conditions Associated with Postpartum Depressive Symptoms?

Background: At least 10-15% of women experience postpartum depression. Prep-conception or prenatal health conditions may be associated with postpartum depressive symptoms. Methods: We assessed data from 4671 women who participated in the 2004-2006 Minnesota Pregnancy Risk Assessment Monitoring System (PRAMS) population-based self-report survey, conducted 2-4 months after delivery of a livebirth. We used SUDAAN software for weighted chi-square analyses. Results: Women who smoked before, during, or after pregnancy were significantly (p < 0.01) more likely to report postpartum depressive symptoms than non-smokers. Compared to those without the condition, women with diabetes (11.9% vs. 27.3%, p-value = 0.05), hypertension (11.9% vs. 24.7%, p-value = 0.03), and asthma (11.5% vs. 18.9%, p < 0.01) were more likely to report postpartum depressive symptoms. Fifteen percent of pre-conception obese women, 13% of underweight women, and 10% of normal-weight women reported postpartum depressive symptoms (p < 0.01). Of women who described their general health prior to pregnancy as “fair” or “poor,” 29% reported postpartum depressive symptoms compared to 16% of those who described their health as “good” and 9.3 % of those who described their health as “very good” or “excellent” (p < 0.01). Conclusion: We found that a diverse range of health conditions and behaviors were significantly associated with postpartum depressive symptoms. It is not clear why, but it may be that women with chronic conditions are more aware of their own mental health functioning, are more comfortable reporting such conditions, and/or experience a slower postpartum physical recovery which could subsequently affect mental well-being.