Effects of a recent pregnancy loss on maternal mental health among women with a recent live birth, PRAMS, 2012-2016 Público

Smith, Julie A. (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/2r36tz47j?locale=pt-BR
Published

Abstract

Background: Approximately 20% of women experienced a pregnancy loss in the United States between 1990 and 2011 (1). Much is known about the adverse association between a pregnancy loss and postpartum depression, but less is known about the experience of postpartum depression after a subsequent live birth. Using data from the Pregnancy Risk Assessment Monitoring System (PRAMS), we sought to (1) estimate the proportion of women with a recent live birth who experienced a pregnancy loss in the 12 months prior to conception and (2) determine if there are differences in self-reported postpartum depression for mothers of a recent live birth who experienced a pregnancy loss in the year before conceiving compared to those without a recent pregnancy loss.

 

Methods: Bivariate and multivariable associations were estimated using predicted marginals from log-binomial regression models. We controlled for confounding by marital status; maternal age, race, and education; previous number of live births; and stress. Additionally, we stratified our multivariable analyses by history of depression/anxiety and by pregnancy intention of the subsequent pregnancy. To account for the complex survey design in PRAMS, all analyses were conducted using SAS-callable SUDAAN.

 

Results: Among women with a recent live birth in the United States, 12.8% conceived their infant within 12 months of a pregnancy loss (SE = 0.4). For these mothers, there was a 15% increase in the prevalence of postpartum depression compared to women with a recent live birth and no recent pregnancy loss (aPR: 1.15, 95% CI: 0.98, 1.36). The effect of a previous pregnancy loss on postpartum depression was stronger for women with a history of depression or anxiety and for those who had not intended to become pregnant.

 

Conclusions: A substantial number of women in the United States with a recent live birth had experienced a pregnancy loss in the 12 months prior to conception. These women may be at an increased risk for postpartum depression, particularly if they have a history of depression or if the subsequent pregnancy was unintended.

Table of Contents

Distribution Agreement………………………………………………….....…………..1

Abstract……………………………………………………………………….......…....….4

Chapter I: Background………………………………………………………….....…....8

    Pregnancy Loss…………………………………………………………………....…...8

    Postpartum Depression and Anxiety………………………………….....…......13

Intersection of Pregnancy Loss and Postpartum Depression/Anxiety.....17

    Statement of Need……………………………………………………………....…...24

Chapter II: Manuscript…………………………………………………………......….26

    Introduction………………………………………………………………….......……26

    Methods………………………………………………………………………........…..28

    Results……………………………………….…………………………………........…32

    Discussion………………………………….……………………………….......……..35

References………………………………………………………………………........…..40

Tables……………………………………………………………………………..........….49

Chapter III: Summary, Public Health Implications,

Possible Future Directions………………………………………………….....…...52

Appendix………………………………………………………………………….........…54

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
School
Department
Subfield / Discipline
Degree
Submission
Language
  • English
Research Field
Palavra-chave
Committee Chair / Thesis Advisor
Partnering Agencies
Última modificação

Primary PDF

Supplemental Files