The Association Between Social Support During Pregnancy and the Development of Postpartum Depressive Symptoms Open Access

Kovac, Alessandra (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/c821gj795?locale=en
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Abstract

BACKGROUND: Postpartum depression (PPD) is the most common complication of child bearing, with nearly 12% of women in the United States experiencing symptoms, and can create two generations of suffering for mother and her child (8). Although still considered “postpartum”, nearly half of PPD episodes actually begin during pregnancy (13). While there is evidence supporting mental and physical health benefits of social support, it is unclear whether social support, specifically during pregnancy, is associated with PPD.

 

OBJECTIVE: The purpose of this study was to examine the association between low social support during pregnancy and the development of self-reported PPD symptoms.

 

METHODS:  Using state-representative survey data from the 2012-2014 Georgia Pregnancy Risk Assessment Monitoring System (PRAMS), the association between low social support during pregnancy and the development of PPD was examined (n = 2,696). Accounting for the complex survey design, weighted descriptive frequencies were conducted and estimated adjusted odds ratios (aORs) and 95% confidence intervals (95% CI) using weighted multivariable logistic regression were estimated.

 

RESULTS: In Georgia, about 8% of mothers suffer from PPD symptoms. When adjusting for maternal age, maternal race and ethnicity, maternal education, marital status, abuse before or during pregnancy, and prevalence of stressful life events (SLEs), Georgia mothers with low social support showed no difference in odds of PPD compared to mothers with high social support (aOR = 1.15; 95% CI: 0.72, 1.83).

 

CONCLUSION: The findings of this secondary analysis did not suggest a significant association between low social support during pregnancy and PPD. Other factors beyond social support, including abuse and SLEs, may help to explain development of PPD. Although inconclusive, these findings have implications for future research on the risk factors associated with PPD.

Table of Contents

Table of Contents

 

Chapter I: Background………….………………………..…………………….…1

Postpartum Depression: A Public Health Problem……………………..…1

Social Support …………………………………..………………………...11

Current Problem and Study Relevance……...………………………….…18

Chapter II: Methodology………….…………..……..…………………..………..20

Research Design………….……………………………………………….20

History of Pregnancy Risk Assessment Monitoring System……………...20

Overview of PRAMS Complex Sampling………..………..……….……..21

Data Collection and Instrument………..………..………..……………….22

Data Retrieval ………...………..………..………..….…..………..………24

Data Selection ………..………..………………..………..………..………25

Statistical Analysis………..………..………..………..………..…………..30

IRB Clearance……...………..………..………..………..………..………..34

Chapter III: Results…….………...………..………..…..……..………..………….35

Study Populatio..………..………..………..………..………..…………….35

Exploratory Analyses………..………..………..………...………..……….35

Characteristics Associated with PPD………..………..……..………..……38

Characteristics Associated with Low Social Support…….……..……..…..40

Multivariate Logistic Regression Analysis………..……...………..………42

Chapter IV: Discussion………..…...……..………..………..…..…..………..…….47

Strengths and Limitations………..………..………..…..………..…………49

Implications and Future Directions………..……….………..………..…….52

Conclusions………..………..………..…...…..………..………..………….53

Appendix I: References………..………...………..…..……..………..…………….54

Appendix II: Tables………..………....………..……....………..………..…………65

 

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