Funded Projects

(SDAS) National PRAMS Data: Prevalence and Risk Factors for Postpartum Depression

Grantee: University of Oklahoma Health Sciences Center
Principal Investigator: Stephen R. Gillaspy
Project Number: R40MC21521
Project Date: 2/1/2011

Age group(s)

• Women/Maternal
• Prenatal

Abstract

Major depression is the fourth leading cause of burden among all diseases, and the leading cause of years lived with disability (WHO, 2001). The impact is greatest for women, with a lifetime risk for major depressive disorder of 20% to 25%, approximately twice the rate seen in men (US Department of HHS, 1993). For women, depression is the leading cause of disease related disability (Kessler, 2003) and the most common complication of childbirth. Postpartum depression (PPD) is associated with significant negative child health outcomes as well continued negative maternal health outcomes. Due to the public health significance of PPD, the reduction of depression after delivery, as a postpartum complication, is one of the Healthy People 2010 (HP, 2010) targets for reduction of maternal illness and complications due to pregnancy. Although it is estimated that 10% - 15% of mothers experience PPD within the first year (O'Hara et al., 1996), there are no national population-based estimates of the prevalence of PPD. This lack of population-based prevalence estimates represents a significant barrier to the successful development of routine screening methods and treatment for PPD. The proposed project will perform secondary data analysis on an existing dataset, the 2009 national Pregnancy Risk Assessment Monitoring System (PRAMS) dataset. PRAMS is a population-based surveillance project administered by the Centers for Disease Control (CDC) with state collaboration. Within each dataset, sampling and noncoverage weights, adjustment factors for nonresponse, and demographic information, obtained by linking to state vital records, are provided. This permits weighted analyses that will yield accurate estimates of the prevalence of PPD in the population. Currently, 36 states participate in PRAMS. The specific aims of the proposed project, using a national sample, are: 1) determine population-based prevalence estimates for self-reported maternal PPD; 2) examine the association between maternal risk factors and self-reported PPD; 3) examine the association between maternal demographic characteristics and self-reported PPD; and 4) examine the relationship between maternal insurance status and access to healthcare and self-reported PPD. The project will employ a series of logistic regression models to address these aims. The successful completion of the proposed project will provide invaluable insight into the prevalence and risk factors associated with PPD. These findings have the potential to inform state and national postpartum depression efforts in the areas of research, screening initiatives, and clinical service delivery. Additionally, the public health significance that maternal postpartum depression represents, and the specific aims of the proposed project, are congruent and vital to three specific Maternal and Child Health Bureau (MCHB) Strategic Research Issues. Specific aim 1 directly corresponds to MCHB strategic research issue #I, public health service systems and infrastructures at the community, State and/or national levels, as they apply to different maternal and child (MCH) populations based on demographic, epidemiological, and/or other factors. Specific aim 2 is congruent to MCHB strategic research issue #IV, promoting the healthy development of MCH populations. Specific aims 3 and 4 correspond to MCHB strategic research issue #II, MCH services and systems of care efforts to eliminate health disparities and barriers to health care access for MCH populations.