Preventing Postpartum Depression Among Black and Latina Mothers

Postpartum depression negatively affects the quality of life and functioning of mothers and is particularly burdensome for minority women. We conducted a randomized controlled trial at a large urban hospital to evaluate the effectiveness of a behavioral educational intervention to prevent postpartum depression among self-identified black and Latina mothers. Black and Latina mothers were recruited during their postpartum hospital stay (N=540) and randomized to a 2-part behavioral educational intervention or usual care. Women who had severe depressive symptoms at baseline were referred for psychiatric assessment/treatment and a priori subgroup analyses were planned to assess impact of the intervention on mothers who did not receive psychiatric referral at baseline. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (EPDS ≥10 vs. <10). We used repeated measures analysis to assess changes in depression over time. Mean age was 28 (range 18-46); 62% were Latina, 38% were black, 63% had Medicaid insurance, and 21% spoke Spanish. After excluding 45 mothers referred for psychiatric assessment/treatment at baseline, positive depression screens were significantly more common among usual care versus intervention post hospitalization: at 1-month (14.4% vs. 7.1%, p=.01), at 3-months (11.4% vs. 6.3%, p=.058) and at 6-months (13.1% vs. 7.5%, p=.068). In repeated measure analysis for up to 6-months of follow up, the intervention was protective against a positive depression screen with an OR of 0.57 (95% CI: 0.37-0.88). A simple, culturally tailored intervention prevented postpartum depression among black and Latina mothers in an urban setting.