Prevalence of depressive symptoms across pregnancy and risk factors for persistent depressive symptoms 13-24 months following birth among Oregon mothers

Background: Perinatal depression has considerable health consequences for both mother and child. Studies have found variation in the prevalence of maternal depression and few have examined persistent depression beyond the first year postpartum. Methods: This longitudinal, population-based study used data from birth certificates, the Oregon Pregnancy Risk Assessment Monitoring Surveillance Survey (PRAMS), and PRAMS-2. 1,911 women with live births in 2004-2005 completed the PRAMS-2 survey in 2006-2008. Women reported depressive symptoms (DS) for four time periods: (1) during pregnancy and (2) 2-6 months postpartum on the PRAMS; and (3) 0-12 months postpartum and (4) 13-24 months postpartum on the PRAMS-2. Logistic regression identified risk factors associated with persistent maternal DS occurring 13-24 months postpartum among women with DS during pregnancy or 2-6 months postpartum. Results: The prevalence of reported DS varied across pregnancy: (1) 16.6% during pregnancy; (2) 11.3% 2-6 months postpartum; (3) 30.6% 0-12 months postpartum; and (4) 22.1% 13-24 months postpartum. Of women reporting DS during pregnancy or 2-6 months postpartum, 48.7% reported DS during the 13-24 months postpartum. Risk factors associated with persistent DS were: low social support (ORa 4.16, p<0.01), traumatic stress (ORa 3.15, p<0.01), and low income (ORa 2.62, p=0.02). Conclusions: Depressive symptoms were common among women in this study and varied across pregnancy. Nearly half of the women reporting DS during pregnancy and in the early postpartum continued to report DS during the second year of their child's life. Low social support, traumatic stress, and low income were all significantly associated with persistent DS.