Association of Postpartum Hormonal Contraception Use with Postpartum Depression Público

Abstract

Objective: Postpartum depression (PPD) affects 13-19% of women after childbirth. Studies suggest that hormonal changes may contribute to PPD, which poses a query for the safety of hormonal contraception use during the postpartum period. We investigate whether there is a possible association between PPD and postpartum hormonal contraceptive use.

Study Design: We analyzed cross-sectional data from the CDC’s Pregnancy Risk Assessment Monitoring System Phase 7 Core Questionnaire, 2012-2015. The study was restricted to women with known live births, no missing PPD information, and those using a method of reversible contraception; a total of 61,790 women were eligible for analysis. Using SAS 9.4, we calculated crude prevalence differences (PDs) and ratios (PRs) as well as adjusted PRs and their 95% confidence intervals (CIs) for the association of hormonal contraception with PPD overall, by method-specific categories, and hormonal subcategories, stratified by history of depression (yes/no).

Results: Among women without a history of depression, 45.5% used a hormonal contraceptive method in the postpartum period and 9.25% had a positive indication of PPD. Among the 9.67% of women with a history of depression, 50.1% reported using a hormonal contraceptive during the postpartum period and 26.2% had PPD symptoms. After controlling for age, race/ethnicity, education, marital status, urban/rural residence, and parity, we found no material association between hormonal contraception and PPD relative to non-hormonal contraception. Women with a history of depression, however, had a 1.21 (95% CI: 1.21-1.21) prevalence ratio of PPD relative to women with no depression history.

Conclusions: Our study highlights the association of both sociodemographic factors and depression history with PPD. Prenatal screening for current depressive symptoms, depressive history, and socioeconomic risks, along with appropriate referral and interventions are needed to help reduce PPD.

Table of Contents

 

1.       1.         Manuscript.....…………………………………………………... 1

a.       Introduction………………………………………… 2

b.       Methods…………………………………………….. 3

c.       Results…………………………………………….... 4

d.       Discussion………………………………………….. 7

e.       References…………………………………………. 11

f.        Table 1……………………………………………... 15

g.       Table 2……………………………………………... 16

h.       Table 3……………………………………………... 17

i.        Supplementary Table 1…………………………….. 18

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Palabra Clave	Postpartum Depression Epidemiology Contraception
Committee Chair / Thesis Advisor	Hogue, Carol, Emory University
Partnering Agencies	CDC

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