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Printable Version
A2023
October 22, 2017
43030.375 - 43030.5
Room Exhibit Hall B2
Factors Play a Role in the Incidence of Postpartum Depression: A Retrospective Cohort Study
Jie Zhou, M.D., Tianyue Mi, M.S., Minxian Liang, M.D.
Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
Disclosures: J. Zhou: None. T. Mi: None. M. Liang: None.
Background Jodi L. Pawluski demonstrated that at least 10% postpartum women suffer from anxiety or depressive disorders. The symptoms of postpartum depression (PPD) include sadness, restlessness and/or agitation and decreased concentration. The prevalence of PPD is estimated at around 10%, which results in negative personal and child developmental outcomes. Lots of physical, psychological and social factors may have influences on PPD. The aim of our study was to evaluate the association between various factors such as anesthesia types, delivery mode, gestational age, BMI of parturients, gender of neonate, APGAR score at 1 minute and 5 minutes, ethnicity and PPD. Methods Retrospective chart review of 20,198 parturients who delivered at the Partners Healthcare System Hospitals from 6/1/2015 to 3/27/2017 was conducted. Data including demographic information, diagnosis and procedures were collected. Other risk factors such as anesthesia mode, delivery mode, gestational age, BMI of parturients, gender of neonate, APGAR score at 1 minute and 5 minutes, ethnicity were included. Logistic regression analysis was used for analysis of associations between these risk factors and PPD. Results In a total of 20,198 parturients, 563 (2.8%) cases with postpartum depression were identified. Our study showed there was a negative association between gestational age and PPD (p-value=0.028), which meant that as gestational age increased, the incidence of PPD actually decreased. BMI of parturients was positively associated with PPD (p-value=0.012). As for the influence of ethnicity, African-American population had lower risk of developing PPD compared to Caucasian population (p-value=0.037). On contrary, there was no difference in the incidence of PPD between Hispanic population and Caucasian population (p-calue>0.05). Other populations such as asian population also had lower risk compared to Caucasian population to develop PPD (p-value=0.008). Neither anesthesia modes, gender of neonate, APGAR scores nor delivery modes had significant associations with the occurrence of PPD. Interestingly, delivering in winter had decreased risk of developing PPD with comparison of that in summer, spring and autum (p-value=0.041, 0.038, 0.003 respectively). Discussion In our study we found the following risk factors: gestational age, ethnicity, BMI of parturients and season had association with the incidence of PPD. One possible reason for the observed association between gestational age and PPD is that as the gestational age increases, pregnant women intend to have better idea of how their fetuses are doing. The significant difference in the risk of developing PPD between Caucasian and other populations may be due to the differences in the socio-economic status among these ethnicities. With increasing BMI, the women in the present study needed more hospital-based maternal outpatient follow-ups and had an increased number of pregnancy-related complications. About the influence of season on the incidence of PPD, it may be due to better care and more psychological support from other people in harsh weather situations. References 1. Di Florio A, The impact of education, country, race and ethnicity on the self-report of postpartum depression using the Edinburgh Postnatal Depression Scale. Psychological medicine. 2017 Apr;47(5):787-99. 2. Pawluski JL, The Neurobiology of Postpartum Anxiety and Depression. Trends in Neurosciences. 2017 Jan 24. 3. Fiala A, Sociodemographic and delivery risk factors for developing postpartum depression in a sample of 3233 mothers from the Czech ELSPAC study. BMC psychiatry. 2017 Mar 21;17(1):104. 4. Silverman ME, The risk factors for postpartum depression: A population‐based study. Depression and anxiety. 2017 Feb 1;34(2):178-87.

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