Pregnancy intention and postpartum depression: secondary data analysis from a prospective cohort.

OBJECTIVE: To assess the relationship between unintended pregnancy and postpartum depression.
DESIGN: Secondary analysis of data from a prospective pregnancy cohort.
SETTING: The study was performed at the University of North Carolina prenatal care clinics. POPULATION/SAMPLE: Pregnant women enrolled for prenatal care at the University of North Carolina Hospital Center.
METHODS: Participants were questioned about pregnancy intention at 15-19 weeks of gestation, and classified as having an intended, mistimed or unwanted pregnancy. They were evaluated for postpartum depression at 3 and 12 months postpartum. Log binomial regression was used to assess the relationship between unintended pregnancy and depression, controlling for confounding by demographic factors and reproductive history. MAIN OUTCOME MEASURES: Depression at 3 and 12 months postpartum, defined as Edinburgh Postpartum Depression Scale score >13.
RESULTS: Data were analysed for 688 women at 3 months and 550 women at 12 months. Depression was more likely in women with unintended pregnancies at both 3 months (risk ratio [RR] 2.1, 95% confidence interval [95% CI] 1.2-3.6) and 12 months (RR 3.6, 95% CI 1.8-7.1). Using multivariable analysis adjusting for confounding by age, poverty and education level, women with unintended pregnancies were twice as likely to have postpartum depression at 12 months (RR 2.0, 95% CI 0.96-4.0).
CONCLUSION: While many elements may contribute to postpartum depression, unintended pregnancy could also be a contributing factor. Women with unintended pregnancy may have an increased risk of depression up to 1 year postpartum.