240317 Is There an Association between Health Services Utilization and Postpartum Depression?

Tuesday, November 1, 2011

Rada Dagher, PhD, MPH , Dpt of Health Services Admin, University of Maryland, College Park, MD
Blakely Pomietto, MPH CHES , School of Public Health, University of Maryland College Park, College Park, MD
Kristen Kjerulff, MA, PhD , Public Health Sciences, Penn State University, Hershey, PA
Junjia Zhu, PhD , Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, PA
Background: We investigated the association of health services use with postpartum depression one month after childbirth. Postpartum depression is an incapacitating and prevalent disorder but scarce studies have examined its relationship with health services use.

Methods: More than 3,000 pregnant women, 18 to 35 years old, and expecting their first child in 2009 to early 2011, were interviewed in Pennsylvania after 34 weeks gestation and one month postpartum. Self-reported health services utilization included outpatient and inpatient services used after hospital discharge. Multiple linear regression was performed with postpartum depression (Edinburgh Postnatal Depression Scale) as the dependent variable.

Results: The women averaged 27 years old, 86% were white, 56% had a college degree and 3.6% met the depression threshold at 1 month postpartum. 10.2% of the women utilized the emergency room, 6.8% visited the hospital, 5.3% had outpatient surgeries, 46% had office visits, 4.5% had mental health visits, and 14% received home visits from a nurse. In multivariate analyses, variables associated with postpartum depressive symptoms were: employment status pre-delivery (B = -0.46), college education (B = 0.63), social support (B = -0.27), having a fussy infant (B = 1.15), increased office visits (B = 0.37), and having had mental health visits (B = 3.15).

Conclusions: Healthcare providers should assess and educate pregnant women about postpartum depression risk factors and explore the need for resources such as counseling, support groups, and primary health services. Future research should ascertain the causal direction of the relationship between health services use and postpartum depression.

Learning Areas:
Chronic disease management and prevention
Social and behavioral sciences

Learning Objectives:
Learning Objectives: By the end of this session, the learner should be able to describe which health services depressed women are more likely to utilize during the first month after childbirth discuss the possible effects of various demographic and psychosocial factors on the risk of postpartum depression

Keywords: Maternal Well-Being, Mental Illness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I ran the statistical analyses for this study, conceptualized the paper, and wrote the abstract
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.