Correlates of self-reports of being very depressed in the months after delivery: results from the Pregnancy Risk Assessment Monitoring System.

Objective: This study identified correlates of self-reports of being very depressed in the months after delivery in a population-based sample of women.

Methods: We analyzed data on 14,609 recent mothers from the Centers for Disease Control and Prevention's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS). The sample included mothers who delivered a live birth in Colorado, New York State, and North Carolina from 1996 (New York only) to 1999. We assessed risk factors for self-reports of being very depressed in the months after delivery using logistic regression.

Results: Overall, 5.9% (95% CI = 5.3, 6.4) of new mothers reported being very depressed in the months after delivery. Women who reported that their pregnancy was a "very hard time" or "one of the worst times of my life" had the highest prevalence of reporting being very depressed in the months after delivery (24.9%, 95% CI = 21.3, 28.5) and, when all risk factors were adjusted for simultaneously, were 4.6 times (95% CI = 3.1, 6.3) more likely to report being very depressed in the months after delivery than other women. Other significant risk factors for self-reports of being very depressed in the months after delivery included experiencing partner-associated stress (OR = 1.9, 95% CI = 1.5, 2.5), physical abuse during pregnancy (OR = 1.6, 95% CI = 1.1, 2.4), and not breast-feeding (OR = 1.4, 95% CI = 1.1, 1.8).

Conclusions: The highest prevalence for self-reports of being very depressed in the months after delivery was in women who reported that their pregnancy was a "very hard time" or "one of the worst times of my life." Clinicians need to be aware of the needs of some women for mental health services both during and after pregnancy.