Pregnancy intention and postpartum depression: secondary data analysis from a prospective cohort.

OBJECTIVE

To assess the relationship between unintended pregnancy and postpartum depression.

DESIGN

Secondary analysis of data from a prospective pregnancy cohort.

SETTING

The study was performed at the University of North Carolina prenatal care clinics.

POPULATION/SAMPLE: Pregnant women enrolled for prenatal care at the University of North Carolina Hospital Center.

METHODS

Participants were questioned about pregnancy intention at 15-19 weeks of gestation, and classified as having an intended, mistimed or unwanted pregnancy. They were evaluated for postpartum depression at 3 and 12 months postpartum. Log binomial regression was used to assess the relationship between unintended pregnancy and depression, controlling for confounding by demographic factors and reproductive history.

MAIN OUTCOME MEASURES

Depression at 3 and 12 months postpartum, defined as Edinburgh Postpartum Depression Scale score >13.

RESULTS

Data were analysed for 688 women at 3 months and 550 women at 12 months. Depression was more likely in women with unintended pregnancies at both 3 months (risk ratio [RR] 2.1, 95% confidence interval [95% CI] 1.2-3.6) and 12 months (RR 3.6, 95% CI 1.8-7.1). Using multivariable analysis adjusting for confounding by age, poverty and education level, women with unintended pregnancies were twice as likely to have postpartum depression at 12 months (RR 2.0, 95% CI 0.96-4.0).

CONCLUSION

While many elements may contribute to postpartum depression, unintended pregnancy could also be a contributing factor. Women with unintended pregnancy may have an increased risk of depression up to 1 year postpartum.