A recent study shows that women living in large urban areas in Canada with more than 500,000 inhabitants are at a higher risk of developing postpartum depression compared with women living in rural areas.

The study, published in the Canadian Medical Association Journal, looked at 6,421 women who participated in the 2006 Canadian Maternity Experiences Survey, who had just given birth.

The researchers, of Women’s College Hospital, Centre for Addiction and Mental Health, St. Michael’s Hospital and the University of Toronto, Ontario, classified which area of Canada the women lived in from the following:

  • Rural area (population smaller than 1,000 people or with 400 or more inhabitants per square kilometer)
  • Semi-rural (population under 30,000)
  • Semi-urban (population between 30,000 – 499,999)
  • Urban (population 500,000 or over).

The researchers also took into account whether residents commuted to urban areas, as they say this can affect the degree of isolation.

The results of the analysis revealed that the prevalence of postpartum depression overall was 7.5%.

However, women living in urban areas had a higher risk of postpartum depression at 10%, compared with 6% of women living in rural areas.

Women living in semi-rural areas had a 7% risk of postpartum depression, while women residing in semi-urban areas had a 5% risk.

The study authors say that urban areas have higher numbers of immigrant populations, and a higher majority of women living in these areas reported lower levels of social support following pregnancy.

The study authors explain:

Our findings suggest that women in urban areas with a large population were at increased risk of postpartum depression compared with women in other regions.

Geographical differences in the distribution of important risk factors for postpartum depression, such as immigration status, interpersonal violence, self perceived health and social support, account for much of this variance.”

Postpartum depression typically affects some women within 4 to 6 weeks after giving birth, but it can take several months to develop.

Symptoms include fatigue, sadness, reduced libido, episodes of crying , anxiety, irritability and irregular sleeping patterns.

According to the American Psychological Association (APA), around 9-16% of women will experience postpartum depression following birth. In women who have already experienced postpartum depression following a previous pregnancy, the risk of them developing it again can increase to 41%.

The researchers conclude that their findings suggest that supports and services targeted toward increasing connections for isolated women in large urban areas may need to be increased in Canada, as well as in other countries.

They add:

“Considering the substantial negative effect of postpartum depression, such interventions could have broad-reaching social and public health impact.

Other countries might also benefit from studying the levels of perceived social support across regions, particularly in cases where geographical variation in the rates of postpartum depression is observed.”