Skip to main content
Top
Published in: Maternal and Child Health Journal 10/2013

01-12-2013

Prevalence and Risk Factors for Postpartum Depressive Symptoms Among Women Enrolled in WIC

Authors: Jennifer Pooler, Deborah F. Perry, Reem M. Ghandour

Published in: Maternal and Child Health Journal | Issue 10/2013

Login to get access

Abstract

The objectives of this study were to determine the prevalence and correlates of postpartum depressive symptoms (PDS) among women with a recent live birth and specifically among women participating in and eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Pregnancy Risk Assessment and Monitoring System data from 22 states in 2006–2008 (n = 75,234) were used to estimate the prevalence of PDS using a two-question screener. Associations between PDS and respondent demographics, risk factors and behaviors, and WIC program eligibility and participation were assessed using logistic regression. Overall prevalence of PDS was 13.8 %:19.8 % among WIC participants, 16.3 % among non-participants eligible for WIC, and 6.8 % of women not eligible for the program. PDS prevalence was higher among younger, less educated, and poorer women, as well as those engaging in risky behaviors during pregnancy (smoking and binge drinking), and those with an unintended pregnancy and who experienced intimate partner violence during pregnancy. Controlling for these factors, the odds of PDS were no different between WIC participants and women eligible but not participating in the program (aOR 1.08, 95 % CI 0.97–1.22), but WIC enrollees were significantly more likely than ineligible women to report PDS (aOR 1.65, 95 % CI 1.39–1.95). WIC serves more than 1 million pregnant women each year, one-fifth of whom may experience PDS. WIC has a unique opportunity to screen and provide referrals to new mothers receiving postpartum WIC benefits.
Footnotes
1
States included in the analyses: Alaska, Colorado, Delaware, Georgia, Hawaii, Maine, Maryland, Massachusetts, Minnesota, Missouri, Nebraska, New York, North Carolina, Ohio, Oregon, Rhode Island, South Carolina, Tennessee, Utah, Washington, Wisconsin, and Wyoming.
 
2
Due to differences in how states collect and report racial and ethnic data to CDC PRAMS, the race groups used in this paper in some cases include persons of multiple races and of Hispanic origin. Where possible, however, race groups were categorized as mutually exclusive.
 
Literature
1.
go back to reference Gaynes, B. N., Gavin, N., Meltzer-Brody, S., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence Report/Technology Assessment (Summary), 119, 1–8. Gaynes, B. N., Gavin, N., Meltzer-Brody, S., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence Report/Technology Assessment (Summary), 119, 1–8.
2.
go back to reference O’Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression: A meta-analysis. International Review of Psychiatry, 8(1), 37–54.CrossRef O’Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression: A meta-analysis. International Review of Psychiatry, 8(1), 37–54.CrossRef
3.
go back to reference Darcy, J. M., Grzywacz, J. G., Stephens, R. L., Leng, I., Clinch, C. R., & Arcury, T. A. (2011). Maternal depressive symptomatology: 16-Month follow-up of infant and maternal health-related quality of life. Journal of the American Board of Family Medicine, 24, 249–257.PubMedCrossRef Darcy, J. M., Grzywacz, J. G., Stephens, R. L., Leng, I., Clinch, C. R., & Arcury, T. A. (2011). Maternal depressive symptomatology: 16-Month follow-up of infant and maternal health-related quality of life. Journal of the American Board of Family Medicine, 24, 249–257.PubMedCrossRef
4.
go back to reference Sohr-Preston, S. L., & Scaramella, L. V. (2006). Implications of timing of maternal depressive symptoms for early cognitive and language development. Clinical Child and Family Psychology, 9(1), 65–83.CrossRef Sohr-Preston, S. L., & Scaramella, L. V. (2006). Implications of timing of maternal depressive symptoms for early cognitive and language development. Clinical Child and Family Psychology, 9(1), 65–83.CrossRef
5.
go back to reference Grace, S. L., Evindar, A., & Stewart, D. E. (2003). The effect of postpartum depression on child cognitive development and behavior: A review and critical analysis of the literature. Archives of Women’s Mental Health, 6(4), 263–274.PubMedCrossRef Grace, S. L., Evindar, A., & Stewart, D. E. (2003). The effect of postpartum depression on child cognitive development and behavior: A review and critical analysis of the literature. Archives of Women’s Mental Health, 6(4), 263–274.PubMedCrossRef
6.
go back to reference Dennis, C.-L., & McQueen, K. (2009). The relationship between infant-feeding outcomes and postpartum depression: A qualitative systematic review. Pediatrics, 123(4), e736–e751.PubMedCrossRef Dennis, C.-L., & McQueen, K. (2009). The relationship between infant-feeding outcomes and postpartum depression: A qualitative systematic review. Pediatrics, 123(4), e736–e751.PubMedCrossRef
7.
go back to reference Gress-Smith, J., Luecken, L., Lemery-Chalfant, K., & Howe, R. (2012). Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Maternal and Child Health Journal, 16(4), 887–893.PubMedCrossRef Gress-Smith, J., Luecken, L., Lemery-Chalfant, K., & Howe, R. (2012). Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Maternal and Child Health Journal, 16(4), 887–893.PubMedCrossRef
8.
go back to reference Hart, S., Jackson, S., & Boylan, L. M. (2011). Compromised weight gain, milk intake, and feeding behavior in breastfed newborns of depressive mothers. Journal of Pediatric Psychology, 36(8), 942–950.PubMedCrossRef Hart, S., Jackson, S., & Boylan, L. M. (2011). Compromised weight gain, milk intake, and feeding behavior in breastfed newborns of depressive mothers. Journal of Pediatric Psychology, 36(8), 942–950.PubMedCrossRef
9.
go back to reference Ertel, K. A., Koenen, K. C., Rich-Edwards, J. W., & Gillman, M. W. (2010). Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paediatric and Perinatal Epidemiology, 24(2), 179–189.PubMedCrossRef Ertel, K. A., Koenen, K. C., Rich-Edwards, J. W., & Gillman, M. W. (2010). Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paediatric and Perinatal Epidemiology, 24(2), 179–189.PubMedCrossRef
10.
go back to reference Brett, K., Barfield, W., & Williams, C. (2008). Prevalence of self-reported postpartum depressive symptoms–17 states, 2004–2005. Morbidity and Mortality Weekly Report, 57(14), 361–366. Brett, K., Barfield, W., & Williams, C. (2008). Prevalence of self-reported postpartum depressive symptoms–17 states, 2004–2005. Morbidity and Mortality Weekly Report, 57(14), 361–366.
11.
go back to reference Boury, J., Larkin, K., & Krummel, D. (2004). Factors related to postpartum depressive symptoms in low-income women. Women and Health, 39(3), 19–34.PubMedCrossRef Boury, J., Larkin, K., & Krummel, D. (2004). Factors related to postpartum depressive symptoms in low-income women. Women and Health, 39(3), 19–34.PubMedCrossRef
12.
go back to reference Robertson, E., Grace, S., Wallington, T., & Stewart, D. (2004). Antenatal risk factors for postpartum depression: a synthesis of recent literature. General Hospital Psychiatry, 26(4), 289–295.PubMedCrossRef Robertson, E., Grace, S., Wallington, T., & Stewart, D. (2004). Antenatal risk factors for postpartum depression: a synthesis of recent literature. General Hospital Psychiatry, 26(4), 289–295.PubMedCrossRef
13.
go back to reference Gross, K., Wells, C., Radigan Garcia, A., & Dietz, P. (2002). Correlates of self-reports of being very depressed in the months after delivery: Results from the Pregnancy Risk Assessment Monitoring System. Maternal and Child Health Journal, 6(4), 247–253.PubMedCrossRef Gross, K., Wells, C., Radigan Garcia, A., & Dietz, P. (2002). Correlates of self-reports of being very depressed in the months after delivery: Results from the Pregnancy Risk Assessment Monitoring System. Maternal and Child Health Journal, 6(4), 247–253.PubMedCrossRef
14.
go back to reference Beck, C. T. (2001). Predictors of postpartum depression: An update. Nursing Research, 50(5), 275–285.PubMedCrossRef Beck, C. T. (2001). Predictors of postpartum depression: An update. Nursing Research, 50(5), 275–285.PubMedCrossRef
15.
go back to reference Centers for Disease Control and Prevention. (2007). Preconception and Interconception health status of women who recently gave birth to a live-born infant—Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 reporting areas, 2004. Morbidity and Mortality Weekly Report, 56(10), 1–35. Centers for Disease Control and Prevention. (2007). Preconception and Interconception health status of women who recently gave birth to a live-born infant—Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 reporting areas, 2004. Morbidity and Mortality Weekly Report, 56(10), 1–35.
16.
go back to reference Segre, L., O’Hara, M., Arndt, S., & Stuart, S. (2007). The prevalence of postpartum depression: the relative significance of three social status indices. Social Psychiatry and Psychiatric Epidemiology, 42(4), 316–321.PubMedCrossRef Segre, L., O’Hara, M., Arndt, S., & Stuart, S. (2007). The prevalence of postpartum depression: the relative significance of three social status indices. Social Psychiatry and Psychiatric Epidemiology, 42(4), 316–321.PubMedCrossRef
17.
go back to reference Price, S., & Proctor, E. (2009). A rural perspective on perinatal depression: Prevalence, correlates, and implications for help-seeking among low-income women. The Journal of Rural Health, 25(2), 158–166.PubMedCrossRef Price, S., & Proctor, E. (2009). A rural perspective on perinatal depression: Prevalence, correlates, and implications for help-seeking among low-income women. The Journal of Rural Health, 25(2), 158–166.PubMedCrossRef
18.
go back to reference Howell, E., Mora, P., & Leventhal, H. (2006). Correlates of early postpartum depressive symptoms. Maternal and Child Health Journal, 10(2), 149–157.PubMedCrossRef Howell, E., Mora, P., & Leventhal, H. (2006). Correlates of early postpartum depressive symptoms. Maternal and Child Health Journal, 10(2), 149–157.PubMedCrossRef
19.
go back to reference Mandal, M., & Cheng, D. (2011). Focus on postpartum depression among Maryland women giving birth, 2004–2008: Maryland Department of Health and Mental Hygiene. Available: www.marylandprams.org. Mandal, M., & Cheng, D. (2011). Focus on postpartum depression among Maryland women giving birth, 20042008: Maryland Department of Health and Mental Hygiene. Available: www.​marylandprams.​org.
20.
go back to reference Halbreich, U. (2005). The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions–the need for interdisciplinary integration. American Journal of Obstetrics and Gynecology, 193(4), 1312–1322.PubMedCrossRef Halbreich, U. (2005). The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions–the need for interdisciplinary integration. American Journal of Obstetrics and Gynecology, 193(4), 1312–1322.PubMedCrossRef
21.
go back to reference Homish, G. G., Cornelius, J. R., Richardson, G. A., & Day, N. L. (2004). Antenatal risk factors associated with postpartum comorbid alcohol use and depressive symptomatology. Alcoholism, Clinical and Experimental Research, 28(8), 1242–1248.PubMedCrossRef Homish, G. G., Cornelius, J. R., Richardson, G. A., & Day, N. L. (2004). Antenatal risk factors associated with postpartum comorbid alcohol use and depressive symptomatology. Alcoholism, Clinical and Experimental Research, 28(8), 1242–1248.PubMedCrossRef
22.
go back to reference Gjerdingen, D., & Yawn, B. (2007). Postpartum depression screening: Importance, methods, barriers, and recommendations for practice. Journal of the American Board of Family Medicine, 20(3), 280–288.PubMedCrossRef Gjerdingen, D., & Yawn, B. (2007). Postpartum depression screening: Importance, methods, barriers, and recommendations for practice. Journal of the American Board of Family Medicine, 20(3), 280–288.PubMedCrossRef
23.
go back to reference Earls, M. F. (2010). The Committee on Psychosocial Aspects of Child and Family Health. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics, 126(5), 1032–1039.PubMedCrossRef Earls, M. F. (2010). The Committee on Psychosocial Aspects of Child and Family Health. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics, 126(5), 1032–1039.PubMedCrossRef
25.
go back to reference National Research Council and Institute of Medicine. (2009). Depression in Parents, parenting, and children: Opportunities to Improve identification, treatment, and prevention. Washington, DC: National Academies Press. National Research Council and Institute of Medicine. (2009). Depression in Parents, parenting, and children: Opportunities to Improve identification, treatment, and prevention. Washington, DC: National Academies Press.
26.
go back to reference Abrams, L., Dornig, K., & Curran, L. (2009). Barriers to service use for postpartum depression symptoms among low-income ethnic minority mothers in the United States. Qualitative Health Research, 19(4), 535–551.PubMedCrossRef Abrams, L., Dornig, K., & Curran, L. (2009). Barriers to service use for postpartum depression symptoms among low-income ethnic minority mothers in the United States. Qualitative Health Research, 19(4), 535–551.PubMedCrossRef
27.
go back to reference Sword, W., Busser, D., Ganann, R., McMillan, T., & Swinton, M. (2008). Women’s care-seeking experiences after referral for postpartum depression. Qualitative Health Research, 18(9), 1161–1173.PubMedCrossRef Sword, W., Busser, D., Ganann, R., McMillan, T., & Swinton, M. (2008). Women’s care-seeking experiences after referral for postpartum depression. Qualitative Health Research, 18(9), 1161–1173.PubMedCrossRef
30.
go back to reference Kroenke, K., Spitzer, R., & Williams, J. B. W. (2003). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284–1292.PubMedCrossRef Kroenke, K., Spitzer, R., & Williams, J. B. W. (2003). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284–1292.PubMedCrossRef
33.
go back to reference Ross, L. E., & Dennis, C.-L. (2009). The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: a systematic review. Journal of Women’s Health, 18(4), 475–486.PubMedCrossRef Ross, L. E., & Dennis, C.-L. (2009). The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: a systematic review. Journal of Women’s Health, 18(4), 475–486.PubMedCrossRef
37.
go back to reference Gordis, L. (2004). Epidemiology (3rd ed.). Philadelphia, PA: Elsevier Health Sciences. Gordis, L. (2004). Epidemiology (3rd ed.). Philadelphia, PA: Elsevier Health Sciences.
38.
go back to reference Gjerdingen, D., Crow, S., McGovern, P., Miner, M., & Center, B. (2009). Postpartum depression screening at well-child visits: Validity of a 2-Question Screen and the PHQ-9. Annals of Family Medicine, 7(1), 63–70.PubMedCrossRef Gjerdingen, D., Crow, S., McGovern, P., Miner, M., & Center, B. (2009). Postpartum depression screening at well-child visits: Validity of a 2-Question Screen and the PHQ-9. Annals of Family Medicine, 7(1), 63–70.PubMedCrossRef
39.
go back to reference Betson, D., Martinez-Schiferl, M., & Giannarelli, L. (2011). National and state-level estimates of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) eligibles and program reach, 2000–2009. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis. Betson, D., Martinez-Schiferl, M., & Giannarelli, L. (2011). National and state-level estimates of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) eligibles and program reach, 2000–2009. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis.
Metadata
Title
Prevalence and Risk Factors for Postpartum Depressive Symptoms Among Women Enrolled in WIC
Authors
Jennifer Pooler
Deborah F. Perry
Reem M. Ghandour
Publication date
01-12-2013
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 10/2013
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-013-1224-y

Other articles of this Issue 10/2013

Maternal and Child Health Journal 10/2013 Go to the issue