Do successive poor birth outcomes increase the risk of postpartum depressive symptoms?

Background

It is well established that poor birth outcomes (PBO) increase the risk of postpartum depression (PPD) in women. However, there is a paucity of research investigating the effect of consecutive PBO on the risk of PPD. This study aims to determine if women with successive PBO have a higher risk of developing postpartum depressive symptoms (PDS) than women with PBO in the current pregnancy.

Methods

Data come from the 2009-2011 national Pregnancy Risk Assessment Monitoring System and linked birth certificate data. Study population included women (N= 54,036) who had singleton births and provided valid responses to questions on preterm birth and low birth weight on two-consecutive births, and PDS. PBO was defined as the birth of a baby born preterm, low birthweight or both, and PDS was defined based on 3 PDS survey questions. Multiple logistic regression was used to examine the relationship, adjusting for potential confounders and accounting for the complex survey design using appropriate analysis weights.

Results

Approximately 28% and 29% of women with successive and current PBO reported PDS, respectively. Women with PBO in the current pregnancy had a 12% higher odds of having PDS (OR, 1.31; 95% CI, 1.13-1.50) than women with successive PBO (OR, 1.19; 95% CI, 1.02-1.40), compared to women without PBO.

Conclusion

This study shows that PBO in the current pregnancy has higher risk of PDS than PBO in consecutive pregnancies. Healthcare providers should be aware of this important risk and women with PBO should be screened for postpartum depression.