Pregnancy Intention and Postpartum depression in The United States

Objectives: Postpartum depression is responsible for a myriad of poor maternal and infant outcomes.  Nearly half of all pregnancies in the U.S. are unintended. The aim of this study is to assess the relationship between pregnancy intention and postnatal depression.

Methods: Data from the national Pregnancy Risk Assessment Monitoring System (PRAMS) 2011 was analyzed. The data included 33,715 women who recently delivered a live-born infant. Pregnancy intention was categorized into intended pregnancy, if the woman wanted the pregnancy sooner or then, and unintended pregnancy, if she wanted the pregnancy later or if pregnancy was not wanted. Postnatal depressive symptoms were assessed using a three item questionnaire that included feeling and experiences of depression, down, hopelessness and slowing down. Odds ratio and 95% confidence intervals were estimated using multiple logistic regression analysis.

Results: Approximately 21% women in the study  had experienced postpartum depressive symptoms. After adjusting for age, race, marital status, education, income, health insurance, prenatal care utilization, and vitamins intake, women who reported history of unintended pregnancy had a 30% higher odds of experiencing postpartum depressive symptoms (AOR =1.3, 95% CI = 1.2 - 1.5 ).

Conclusion: Unintended pregnancy and postpartum depression are highly prevalent public health problems in the United States. While there are many factors that might influence depression during pregnancy and shortly after delivery, pregnancy intention is a significant predictor that can be prevented.