Postpartum anxiety and comorbid depression in a population-based sample of women

Abstract

Background: Population-based estimates of prevalence of anxiety and comorbid depression are lacking. Therefore, we estimated the prevalence and risk factors for postpartum anxiety and comorbid depressive symptoms in a population-based sample of women.

Methods: Using multinomial logistic regression, we examined the prevalence and risk factors for postpartum anxiety and depressive symptoms using 2009-2010 data from the Illinois and Maryland Pregnancy Risk Assessment Monitoring System, a population-based survey of mothers who gave birth to live infants. Survey participants are asked validated screening questions on anxiety and depressive symptoms.

Results: Among 4451 postpartum women, 18.0% reported postpartum anxiety symptoms, of whom 35% reported postpartum depressive symptoms (6.3% overall). In the multivariable model, higher numbers of stressors during pregnancy (adjusted odds ratio [aOR] range: 1.3-9.7) and delivering an infant at ≤27 weeks gestation (aOR range: 2.0-5.7) were associated with postpartum anxiety and postpartum depressive symptoms, experienced individually or together. Smoking throughout pregnancy was associated with postpartum anxiety symptoms only (aOR=2.3) and comorbid anxiety and depressive symptoms (aOR=2.9).

Conclusions: Given the possible adverse effects of postpartum anxiety and comorbid depression on maternal health and infant development, clinicians should be aware of the substantial prevalence, comorbidity, and risk factors for both conditions and facilitate identification, referral, and/or treatment.

FIG. 1.

Percentage of women reporting types of prenatal stressful life events by postpartum anxiety and depressive symptoms, Pregnancy Risk Assessment Monitoring System, Maryland and Illinois, 2009–2010. *Chi square p-value < 0.05.