Abstract
Whether there has been an increase in postpartum depression (PPD) over the generation remains unknown. This study aimed to compare the prevalence in two cohorts of young Australian women born 17 years apart and identified the factors associated with any generational differences. Participants were from the Australian Longitudinal Study on Women’s Health, who gave birth between ages 18 and 27 (born in 1973–78 and 1989–95). PPD prevalence was calculated as the percentage of births associated with PPD. Both the prevalence of PPD diagnoses (among 1,610 births) and PPD symptoms (among 953 births) were compared. Relative risks (RRs) and 95% confidence intervals (CIs) were used to report generational differences in the prevalence for PPD diagnoses; Hazard ratios (HRs) and 95% CIs used for PPD symptoms. Factors that differed between cohorts and were associated with PPD diagnoses or PPD symptoms were adjusted. The prevalence of both PPD diagnoses (21.4% vs 10.3%; crude RR: 2.03, 95% CI: 1.59–2.60) and symptoms (20.1% vs 13.3%; crude HR: 1.60, 95% CI: 1.15–2.34) were higher in the 1989–1995 cohort than the 1973–1978 cohort. Generational differences in PPD diagnoses persisted after controlling for potential contributors (RR: 1.53, 95% CI: 1.15–2.04), while generational differences in PPD symptoms were attenuated (HR: 0.98, 95% CI: 0.64–1.49). Of all contributing factors, a history of depression explained most of the generational differences, especially in PPD symptoms (49%), to the extent that when the study sample was stratified by history of depression, no generational differences were detected (without prior depression, HR: 0.65, 95% CI: 0.20–2.08; with prior depression, HR: 1.18, 95% CI: 0.71–1.96). The higher prevalence of PPD in the recent generation was mainly due to the high prevalence of depression. Strategies that well manage pre-existing depression may benefit the prevention of PPD for the current young generation. Further research is warranted to inform detailed prevention approaches.
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Data may be made available to collaborating researchers where there is a formal request to make use of the material. Please find details at http://www.alswh.org.au/how-to-access-the-data/alswh-data.
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Acknowledgements
The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health by the University of Queensland and the University of Newcastle. We are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data.
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This work was supported by the Australian Government Department of Health. Sifan Cao holds the UQ Research Training Scholarship. Gita Devi Mishra is supported by the National Health and Medical Research Council Principal Research Fellowship (APP1121844). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or decision to publish.
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Sifan Cao, Mark Jones, Leigh Tooth, and Gita Devi Mishra designed the study; Sifan Cao, Mark Jones and Gita Devi Mishra finalised the statistical plan; Sifan Cao conducted the statistical analysis and drafted the paper under the supervision of Mark Jones, Leigh Tooth, and Gita Devi Mishra; all co-authors edited the draft of the paper.
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Ethical approvals for the project were granted from the Human Research Ethics Committees of the University of Newcastle (Approval No. H-076–0795) and the Medical Research Ethics Committee of the University of Queensland (Approval No. 2004000224 and 2012000950). All participants gave signed informed consent, and all data used in the analyses were de-identified.
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Cao, S., Jones, M., Tooth, L. et al. Generational differences in the prevalence of postpartum depression among young Australians: a comparison of two cohorts born 17 years apart. Arch Womens Ment Health 25, 199–214 (2022). https://doi.org/10.1007/s00737-021-01182-9
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DOI: https://doi.org/10.1007/s00737-021-01182-9