Do antenatal religious and spiritual factors impact the risk of postpartum depressive symptoms?

OBJECTIVES Previous research has identified an inverse relationship between religiosity/spirituality and depressive symptoms. However, prospective studies are needed. This study investigates the association between antenatal religiosity/spirituality and postpartum depression, controlling for antenatal depressive symptoms, social support, and other potential confounders. METHODS This is a prospective cohort study. Women receiving prenatal care were enrolled from three obstetrics practices. Follow-up assessment was conducted at the 6-week postpartum clinic visit. Four measures of religiosity and two measures of spirituality were assessed at baseline. A measure of overall religiosity/spirituality was also created using principal component factor analysis. Depressive symptoms were measured at baseline and again at follow-up using the Edinburgh Postnatal Depression Scale (EPDS). A cutoff score of >or=13 was used to identify women with significant depressive symptoms. RESULTS Four hundred four women were enrolled, and 374 completed follow-up. Thirty women experienced pregnancy loss, leaving 344 with postpartum assessment; 307 women had complete data and were used for analyses. Thirty-six women (11.7%) scored above the EPDS screening cutoff. Controlling for significant covariates (baseline EPDS score and social support), women who participated in organized religious activities at least a few times a month were markedly less likely (OR = 0.18, 95% CI) to exhibit high depressive symptom scores. No other religiosity/spirituality measure was statistically significant. CONCLUSIONS Organized religious participation appears to be protective from postpartum depressive symptoms. Because this association is independent of antenatal depressive symptoms, we hypothesize that religious participation assists in coping with the stress of early motherhood.