The US Centers for Disease Control and Prevention analyzed data on post partum depressive symptoms (PDS) among mothers in America from 2004 to 2005 and found that young, unmarried women with lower levels of education, who were on Medicaid when delivered of their babies were the most likely to report having PDS.

The full report is published in this week’s issue of the CDC’s MMWR (Morbity and Mortality Weekly Report) and recommends that mental health services aim messages about treatments for PPD (postpartum depression) more specifically at women in this group.

PPD affects up to 15 per cent of mothers in the first twelve months after giving birth, said the CDC, whose investigators analysed the prevalence of PDS among mothers using self-reported survey data to find out which factors identified the groups most likely to develop PDS.

The survey covered more than 52,000 mothers in 17 states who had given birth between two and six months previously. Response rates were at least seventy per cent.

The survey included the following two questions:

  • Since your new baby was born, how often have you felt down, depressed, or hopeless?
  • Since your new baby was born, how often have you had little interest or little pleasure in doing things?

The response choices were “always”, “often”, “sometimes”, “rarely” and “never”.

Women who responded with “often” or “always” to either of the two questions were classed as experiencing self-reported PDS.

The CDC said mental health professionals often use these two questions in case finding.

The results showed that the prevalence of self-reported PDS among new mothers ranged from 11.7 per cent in Maine to 20.4 per cent in New Mexico.

Giving birth to a lower than average weight baby, or having the baby admitted to intesive care was also linked to self-reported PDS in most states.

The survey also asked about stressors during pregnancy. These were classed as emotional (for instance the loss of someone close to the respondent), financial (for example having a lot of bills they can’t pay), partner-related stressors (for instance the partner did not want her to have the baby), and traumatic (for instance being made homeless or being in a physical fight).

The results also showed that PDS was most often reported by mothers who were in their teens, who had less than 12 years of education, who were on Medicaid when the baby was delivered, were victims of violence, smoked, and experienced financial or traumatic stress during their pregnancy.

The CDC pointed out that giving birth can be associated with a range of depressive disorders, from “baby blues” to PPD. Baby blues are more prevalent and occur within the first few weeks of delivery, they are also less severe and do not require treatment.

PPD on the other hand, can strike up to a year after delivery. It is significantly more severe than baby blues and needs treatment, said the CDC.

PPD affects the wellbeing of both mother and baby. The CDC report refers to a study published in 2006 that showed mothers who reported PDS were less likely to do things that helped their child develop, such as playing with their baby.

The CDC said women should seek help if they have PDS, not just for themselves but for the sake of their babies.

An editorial comment from the CDC at the end of the MMWR report notes that:

“The American College of Obstetricians and Gynecologists includes screening for PPD among the essential parts of a women’s 4-6 week postpartum visit.”

The CDC also suggested that new mothers could be screened for PPD by pediatricians when they bring their new babies to the well-child clinic. Women who report having PDS in these screenings should then be given a full diagnostic interview since they may be on the road to developing PPD, said the CDC.

“Prevalence of Self-Reported Postpartum Depressive Symptoms, 17 States, 2004-2005.”
US Centers for Disease Control and Prevention (CDC).
MMWR (Morbity and Mortality Weekly Report) April 11, 2008, Vol. 57, No. 14

Click here for the issue of MMWR that contains the full report (PDF download).

Source: CDC.

Written by: Catharine Paddock, PhD