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Poor Prepregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

Published:February 25, 2011DOI:https://doi.org/10.1016/j.whi.2011.01.002

      Abstract

      Purpose

      Mental health problems disproportionately affect women, particularly during the childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy.

      Methods

      We examined data on 1,863 mothers from 11 panels of the 1996–2006 Medical Expenditure Panel Survey. Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.”

      Results

      Of the women included, 9.5% reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor prepregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between prepregnancy and postpartum mental health problems. Additionally, significant disparities exist in women’s report of postpartum mental health status.

      Conclusion

      Although poor antepartum mental health is the strongest predictor of postpartum mental health problems, prepregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health because they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond.
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      1. Agency for Healthcare Research and Quality (AHRQ). (2010). Medical Expenditure Panel Survey (MEPS). Available: http://www.meps.ahrq.gov. Accessed December 3, 2010.

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      Biography

      Whitney P. Witt, PhD, MPH, is an Assistant Professor in the Department of Population Health Sciences at the School of Medicine and Public Health at University of Wisconsin, Madison and the Co-Director of BioPop: Integrative Biopsychosocial Research in Population Health.

      Biography

      Lauren E. Wisk, BS, is a doctoral student in the Department of Population Health Sciences at the School of Medicine and Public Health at University of Wisconsin, Madison.

      Biography

      Erika R. Cheng, BS, is a doctoral student in the Department of Population Health Sciences and a master's student at the La Follette School of Public Affairs at the University of Wisconsin, Madison.

      Biography

      John M. Hampton, MS, is a researcher and statistician for the University of Wisconsin Carbone Cancer Center at the University of Wisconsin, Madison.

      Biography

      Paul D. Creswell, BA, is a doctoral student in the Department of Population Health Sciences at the School of Medicine and Public Health at University of Wisconsin, Madison.

      Biography

      Erika W. Hagen, PhD, MS, is a researcher in the Department of Population Health Sciences at the School of Medicine and Public Health at University of Wisconsin, Madison.

      Biography

      Hilary A. Spear, BA, is a nursing student in the College of Nursing at the University of Colorado, Denver.

      Biography

      Torsheika Maddox, MS, is a doctoral student in the Department of Sociology and a master's student in the Department of Population Health Sciences at the University of Wisconsin, Madison.

      Biography

      Thomas DeLeire, PhD, is an Associate Professor in the Department of Population Health Sciences, the La Follette School of Public Affairs, and the Department of Economics at the University of Wisconsin, Madison and the interim Director of the Population Health Institute.