Online Program

Different Pathways to Pospartum Depression: Early-onset versus Late-onset Depression

Wednesday, November 4, 2015

Catherine L. Kothari, PhD, Department of Biomedical Sciences, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
Amy B. Curtis, PhD, MPH, Interdisciplinary Health Sciences PhD Program/Health Data Research Analysis and Mapping (HDReAM) Center, Western Michigan University, Kalamazoo, MI
R. Shama Tareen, MD, Department of Psychiatry, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
Michael R. Liepman, MD, DABAM, DLFAPA, FASAM, Psychiatry Department, Western Michigan Unviersity Homer Stryker MD School of Medicine, Kalamazoo, MI
Objectives:  To determine the demographic, psychosocial and depression characteristics distinguishing women experiencing early-onset versus late-onset postpartum depression (PPD).

Method: This was a prospective, longitudinal telephone survey of 249 women, recruited on the postpartum hospital floor and contacted at two-weeks, two-months, six-months and eighteen-months following delivery.  Depression was measured using the Edinburgh Postnatal Depression Scale (EPDS). Two-tailed statistical analyses with significance levels set at p≤.05  were conducted using Pearson Chi Square and ANOVA with Bonferroni correction to compare no-PPD-onset, early-PPD-onset and late-PPD-onset women.

Results: Compared to the no-PPD-onset group(n=212), both early-PPD-onset(n=22) and late-PPD-onset(n=15) women were more likely to be minority race, single, have prior history of depression, history of adult trauma, prenatal smoking and other substance use.  Additionally, the early-PPD-onset group was more likely to have low socioeconomic-status(45.5%vs.20.8%), have housing problems(27.3%vs.2.4%), be adolescent(18.2%vs.3.3%), have “not very/not at all helpful” family/friends(18.2%vs.1.0%) and enter prenatal care late(27.3%vs.8.5%) compared to the no-PPD-onset group.  In contrast, the late-PPD-onset group was uniquely different from the no-PPD-onset group on a single characteristic, having delivered a low birth weight infant(13.3%vs.1.9%).

Implications: The early-onset group, with more severe depression, fit the traditional psychosocial risk profile for postpartum depression, while the late-onset group shared characteristics with both non-depressed women (higher socioeconomic status, family/friend support, healthcare access) as well as with early-onset depressed women (minority, lack of supportive partner, history of depression, prenatal smoking and drug use). We speculate that the late-PPD-onset group included more women whose children may have been experiencing delays or disabilities related to their low birth weight.

Learning Areas:

Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Compare the demographic, psychosocial and depressive characteristics of women experiencing early-onset versus late-onset postpartum depression Discuss the implications for prevention, screening and intervention for early-onset and late-onset women

Keyword(s): Depression, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived of the study design, conducted the data collection, analysed the data and interpreted study results. I was the co-PI on a Blue Cross Blue Shield of Michigan Foundation grant to address maternal depression.
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.