How Much Does Low Socioeconomic Status Increase the Risk of Prenatal and Postpartum Depressive Symptoms in First-Time Mothers?

Published:February 04, 2010DOI:


      To examine socioeconomic status (SES) as a risk factor for depressive symptoms in late pregnancy and the early postpartum period. A secondary objective was to determine whether SES was a specific risk factor for elevated postpartum depressive symptoms beyond its contribution to prenatal depressive symptoms.


      Quantitative, secondary analysis, repeated measures, descriptive design.


      Participants were recruited from paid childbirth classes serving upper middle class women and Medicaid-funded hospitals serving low-income clients in Northern California.


      A sample of 198 first-time mothers was assessed for depressive symptoms in their third trimester of pregnancy and at 1, 2, and 3 months postpartum.

      Main Outcome Measure

      Depressive symptoms were measured with the Center for Epidemiological Studies-Depression (CES-D) Scale.


      Low SES was associated with increased depressive symptoms in late pregnancy and at 2 and 3 months, but not at 1 month postpartum. Women with four SES risk factors (low monthly income, less than a college education, unmarried, unemployed) were 11 times more likely than women with no SES risk factors to have clinically elevated depression scores at 3 months postpartum, even after controlling for the level of prenatal depressive symptoms.


      Although new mothers from all SES strata are at risk for postpartum depression, SES factors including low education, low income, being unmarried, and being unemployed increased the risk of developing postpartum depressive symptoms in this sample.
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      Deepika Goyal, PhD, RN, FNP, is an Associate Professor in the School of Nursing at San Jose State University, San Jose, California. She is also a family nurse practitioner and works in Los Gatos, California.


      Caryl Gay, PhD, is a Research Specialist in the Department of Family Health Care Nursing at University of California, San Francisco.


      Kathryn Lee, RN, PhD, FAAN, CBSM, is a Professor and the James and Marjorie Livingston Chair in the Department of Family Health Care Nursing at University of California, San Francisco.