Stressful life events as risk factors for self-reported postpartum depression among American Indian and Alaska Native mothers

Background. The prevalence of stressful life events (SLEs), including intimate partner violence (IPV), is disproportionately high among American Indian/Alaska Native (AI/AN) women in Oregon, which may contribute to the similarly high prevalence of postpartum depression within these communities. Methods. Analysis was conducted using linked data from birth certificates, Oregon's Pregnancy Risk Assessment Monitoring System (PRAMS), and PRAMS-2, Oregon's PRAMS follow-back survey (unweighted n= 226 AI/AN women). PRAMS-2 asks mothers to report symptoms of depression, thirteen separate SLEs, and five types of IPV, occurring 13-24 months after the birth of their child. The SLEs were divided into four categories: partner-related, traumatic, financial, and emotional. Bivariate and multivariate logistic regression models were created to examine risk factors for postpartum depression among AI/AN mothers. All statistical analysis was conducted using STATA 11.0, to account for the complex sampling design of PRAMS and PRAMS-2. Results. 29.4% of AI/AN mothers reported symptoms of depression in their baby's second year. The final multivariate model included two categories of SLEs, which were statistically significantly associated with increased odds of postpartum depression among AI/AN mothers in this sample. These were partner-related SLEs (adjusted odds ratio (aOR)=3.75, 95% Confidence Interval (CI)=1.88-7.50) and traumatic SLEs (aOR=2.89, 95% CI=1.44-5.85). Conclusions. AI/AN mothers in Oregon experience a high prevalence of postpartum depression, for which partner-related and traumatic SLEs are statistically significant risk factors. Interventions to address postpartum depression among AI/AN mothers in Oregon could focus on prevention of these SLEs, or targeted screening of women who are known to have experienced them.