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. 2025 Jan-Dec:21:17455057251338368.
doi: 10.1177/17455057251338368. Epub 2025 May 15.

Number of significant life events and perinatal depression in a diverse rural population: A brief report of a cross-sectional study

Marcia Williams  1   2 , Eli Iacob  2 , Ryoko Kausler  2   3 , Sara E Simonsen  2 , Tumilara Aderibigbe  2 , Gwen Latendresse  2
Affiliations

Number of significant life events and perinatal depression in a diverse rural population: A brief report of a cross-sectional study

Marcia Williams et al. Womens Health (Lond). 2025 Jan-Dec.

Abstract

Background: Significant life events (SLEs) correlate with perinatal depression (PD) risk; however, little is known about this association in rural populations.

Objectives: Using the Neuman systems model, we hypothesized that individuals with higher SLEs would have higher PD risk, and we evaluated this association with data collected from six of Utah's diverse rural health districts.

Design/methods: This cross-sectional study included pregnant and postpartum individuals visiting six rural public health clinics who completed screening with the Edinburgh Postnatal Depression Scale (EPDS) and an 8-item SLE assessment in Spanish or English. Multinomial logistic regression assessed the association between SLEs (0, 1, and ⩾2) and PD risk status (EPDS ⩾9).

Results: Data from 4245 screening surveys identified 2 primary racial groups: white (79.8%) and American Indian/Alaska Native (7.6%), with 20.2% of individuals identifying as Hispanic. Overall, 49.4% of individuals reported one SLE and 10.5% reported two or more SLEs. Significant predictors for PD risk included 1 SLE (OR = 1.84, 95% CI [1.56, 2.15]) or ⩾2 SLEs (5.18, 95% CI [4.31, 6.23]), regardless of racial/ethnic background.

Conclusion: Screening for PD risk in a rural population should include an assessment of SLEs, given the relationship between the two. Improving culturally appropriate local resources to support individuals and their families during the childbearing year should be considered, particularly for those experiencing SLEs.

Keywords: Utah Department of Health; diversity; maternal mental health; perinatal depression; rural; significant life events.

Plain language summary

The relationship between significant life events and perinatal depression in non-urban persons with different ethnicitiesWhy was the study done? Experiencing stressful events can make it harder for a person to cope with internal and external stressors, which can increase the risk of perinatal depression (PD). This connection needs more study, especially in rural areas. This study uses the Neuman Systems Model (NSM), which looks at different kinds of stressors such as those within a person, between people, and external factors that can disrupt balance.What did the researchers do? The study described the connection between stressful life events (SLEs) and perinatal depression (PD) in a rural population of pregnant and postpartum individuals to test the idea that more SLEs are linked to a higher risk of PD. This study used a cross-sectional design, meaning data was collected at one point in time. The study team looked at pregnant and postpartum individuals visiting six rural public health clinics in remote areas of Utah. Individuals completed a survey that included questions about their demographics, the Edinburgh Postnatal Depression Scale (EPDS) assessing mental health, and eight questions about significant life events (SLEs) in the past 12 months. SLEs included events like job loss, trouble paying bills, relationship problems, abuse, and moving. The team looked at relationships between SLEs and the risk of PD, considering factors like race, ethnicity, age, and insurance type.What did the researchers find? Among the 4245 individuals, common SLEs reported were trouble paying bills (24.1%) and moving (25.9%). 26.3% of individuals had a positive screen for PD (EPDS >=9). Individuals with one SLE had almost a two-fold increase in PD risk, while those with two or more SLEs had the greatest risk. Specifically, the adjusted odds ratio for one SLE was 1.84, and for two or more SLEs was 5.18.What does this mean? In this western rural region, over 26% showed a positive screen for perinatal depression. Experiencing multiple SLEs increased the risk for PD. Screening for SLEs should be part of routine screening to improve mental health among rural childbearing persons.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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