The Effect of Stressful Life Events on Postpartum Depression Results from the 1997-1998 North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS)

Objective: Among mothers with recent births, we identify the effects of self-reported stressful life events in the year before delivery on the risk of postpartum depression (PPD). Methods: Survey data (1997-1998) from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) were used to evaluate the impact of both the quantity of stress and individual stressors on the risk of PPD. In the analyses, we controlled for several important risk characteristics known to elevate a mother’s chances of having PPD, i.e., young maternal age, low socioeconomic status, physical abuse during pregnancy, and very low birth weight. The stressful life event items were those occurring during the 12 months before delivery. Results: Based on the PRAMS Survey, an estimated 7.5 percent of North Carolina mothers had PPD. This group included mothers who reported being either “very depressed” or “very depressed and had to get help.” The occurrence of six or more potentially stressful events during the 12 months before delivery proved to be a strong independent risk factor for PPD. Furthermore, mothers who reported losing their job (even though they wanted to continue working) or reported being overwhelmed with bills to pay had a two-fold risk of PPD, compared to mothers who did not experience these economic adversities. Conclusion: A significant proportion of mothers experienced PPD. Moreover, mothers with the highest levels of prenatal stress had the highest risk for PPD. To promote awareness and treatment of PPD, pregnant women should be routinely advised of the signs and symptoms of postpartum depression. SCHS Studies NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES A Special Report Series by the State Center for Health Statistics 1908 Mail Service Center, Raleigh, N.C. 27699-1908 www.schs.state.nc.us/SCHS/ North Carolina Public Health