Postpartum depression on the decline
Rates of postpartum depression (PDS) reported by women fell 5% between 2004 and 2012, according to a new report from the Centers for Disease Control and Prevention (CDC). Published in Morbidity and Mortality Weekly Report, the findings underscore disparities in prevalence of self-reported PDS at the state level and in certain subgroups of women.
The data are from the Pregnancy Risk Assessment Monitoring System (PRAMS). Through PRAMS, state-specific data are collected, on an ongoing basis, about maternal attitudes and experiences before, during, and soon after pregnancy among women who had a live birth in the preceding 2 to 9 months. The number of states completing the survey varies from year to year.
The report on PDS reflects information from states that met response rates for 2004, 2008, and 2012. More than 1.6 million women were included in the sample, from 27 reporting states and representing 41% of US births. They were asked to respond with “always,” “often,” “sometimes,” “rarely” or “never” to two questions: 1) Since your new baby was born, how often have you felt down, depressed or hopeless? and 2) Since your new baby was born, how often have you had little interest or little pleasure in doing things?
Based on the women’s answers, the CDC found that prevalence of PDS declined from 14.8% to 9.8% between the 2004 and 2012 surveys among 13 states for which data were available for all three study periods (P<0.01). Eight states—Alaska, Colorado, Georgia, Hawaii, Minnesota, Nebraska, Utah, and Washington—had statistically significant reductions (P<0.05) in PDS. Five states—Maine, Maryland, Oregon, Rhode Island, and Vermont—had no statistically significant changes in prevalence.
Prevalence of PDS was highest in new mothers who were aged ≤19 years or 20-24 years, of American Indiana/Alaska Native or Asian/Pacific Islanders, had ≤12 years of education, were unmarried, were postpartum smokers, had 3 or more stressful live events in the year before birth, gave birth to term low-birthweight infants, and had infants that required neonatal intensive care unit admission at birth.
The findings, the authors said, underscore the need for universal screening and appropriate treatment for pregnant and postpartum women with PDS. They noted, however, that the findings have three limitations: 1) the self-reports might not represent a clinical diagnosis of depression; 2) the data may not be generalizable to states not included in the analysis or pregnancies that didn’t result in a live birth; and 3) mental health treatment over time could not be assessed because data in PRAMS on that are limited.