Rebecca Ganann1, Wendy Sword2, Lehana Thabane3, Bruce Newbold4, Margaret Black1. 1. 1 School of Nursing, McMaster University , Hamilton, Canada . 2. 2 School of Nursing, University of Ottawa , Ottawa, Canada . 3. 3 Department of Clinical Epidemiology and Biostatistics, McMaster University , Hamilton, Canada . 4. 4 School of Geography and Earth Sciences, McMaster University , Hamilton, Canada .
Abstract
BACKGROUND: Immigrant women are at increased risk for postpartum depression (PPD). The factors that influence PPD among immigrant women are poorly understood. The purpose of this study was to identify individual- and community-level factors predictive of PPD among immigrant women living in a large Ontario city at 6 weeks, 6 months, and 1 year postpartum. METHODS: The study involved a secondary analysis of a prospective cohort study, The Ontario Mother and Infant Study 3. This study included 519 immigrant women who were recruited from two hospitals in one urban city and delivered full-term singleton infants. Women completed a written questionnaire in hospital, followed by structured telephone interviews at 6 weeks, 6 months, and 1 year after hospital discharge. Generalized estimating equations were used to explore factors associated with PPD, measured using the Edinburgh Postnatal Depression Scale (EPDS) and two thresholds for depression (≥12 and ≥9). RESULTS: Rates of PPD at all time points were 8%-10% for EPDS scores of ≥12. For EPDS scores of ≥9, rates of PPD more than doubled at all time points. A lack of social support was strongly associated with PPD in all analyses. Living in Canada for ≤2 years, poor perceptions of health, and lower mental health functioning were other important predictors of PPD. Living in communities with a high prevalence of immigrants and low income also was associated with PPD. CONCLUSIONS: Complex individual and community-level factors are associated with PPD in immigrant women. Understanding these contextual factors can inform a multifaceted approach to addressing PPD.
BACKGROUND: Immigrant women are at increased risk for postpartum depression (PPD). The factors that influence PPD among immigrant women are poorly understood. The purpose of this study was to identify individual- and community-level factors predictive of PPD among immigrant women living in a large Ontario city at 6 weeks, 6 months, and 1 year postpartum. METHODS: The study involved a secondary analysis of a prospective cohort study, The Ontario Mother and Infant Study 3. This study included 519 immigrant women who were recruited from two hospitals in one urban city and delivered full-term singleton infants. Women completed a written questionnaire in hospital, followed by structured telephone interviews at 6 weeks, 6 months, and 1 year after hospital discharge. Generalized estimating equations were used to explore factors associated with PPD, measured using the Edinburgh Postnatal Depression Scale (EPDS) and two thresholds for depression (≥12 and ≥9). RESULTS: Rates of PPD at all time points were 8%-10% for EPDS scores of ≥12. For EPDS scores of ≥9, rates of PPD more than doubled at all time points. A lack of social support was strongly associated with PPD in all analyses. Living in Canada for ≤2 years, poor perceptions of health, and lower mental health functioning were other important predictors of PPD. Living in communities with a high prevalence of immigrants and low income also was associated with PPD. CONCLUSIONS: Complex individual and community-level factors are associated with PPD in immigrant women. Understanding these contextual factors can inform a multifaceted approach to addressing PPD.
Authors: Nihaya Daoud; Kristen O'Brien; Patricia O'Campo; Sarah Harney; Evelyn Harney; Kerry Bebee; Cheryllee Bourgeois; Janet Smylie Journal: Can J Public Health Date: 2019-02-14