Psychosocial factors in postpartum depression

This study examined 214 New Zealand women, both during pregnancy and in the postpartum, in order to determine the influence of infant-related stressors, unplanned pregnancy, social support and the role of the marital relationship in the development of postpartum depression. The relationship of demographic factors, the woman's feelings about having a new baby in the family and previous history of depression were also analyzed. The prevalence of depressive symptomatology was 30.8% during pregnancy and 39.7% in the postpartum. Postpartum depression was predicted by depression during pregnancy, by poorer postpartum marital adjustment and by lower levels of postpartum social support. The strongest predictor of the change in depression scores over time was depression during pregnancy. The important role of depression during pregnancy in the etiology of postpartum depression, suggests that postpartum depression is a continuation of depression during pregnancy. Women who were more depressed during pregnancy tended to be younger, of lower socio-economic status, and to have a reported history of depressive episodes prior to their pregnancies. Higher levels of prepartum depression were also related to women's feelings of being unhappier about having a new baby in the family, to poorer marital adjustment, and to lower levels of social support during pregnancy. Depression during pregnancy was found to be more likely to have a negative effect on marital adjustment than poor marital adjustment on depression. Similarly, depression during pregnancy was found to be more likely to have a negative effect on social support, than vice versa. However, further regression analyses, showed that postpartum marital adjustment and postpartum social support had a strong relation to postpartum depression, irrespective of the levels of prepartum marital adjustment, prepartum social support, and prepartum depression. Contrary to predictions, neither infant temperament, nor infant risk were related to postpartum depression