An Integrative Review of Postpartum Depression in Rural U.S. Communities

Mollard, Elizabeth; Hudson, Diane Brage; Ford, Amy; Pullen, Carol H.

doi:10.1016/j.apnu.2015.12.003

Cited by 41 publications

(66 citation statements)

References 45 publications

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“…Understanding the reasons for this problem requires consideration of the social, economic and geographical environments in which mothers live, which can greatly differ within a given country. International data, including from high-income, middle-income and low-income countries, suggest that perinatal mental illness is more prevalent in rural women compared to their urban counterparts and to the general population (2,3). Other negative outcomes have been reported to be more frequent in women from rural areas including later initiation of prenatal care (4), later and less use of contraceptives (5), as well as higher chances of a small-for-gestational-age birth and low birthweight (6), all of which may add to stress levels and increase the risk of mental illness.…”

Section: Introductionmentioning

confidence: 99%

Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study

Ginja

Jackson

Newham

et al. 2020

Preprint

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Abstract Background: International data suggest that living in a rural area is associated with an increased risk of perinatal mental illness. This study tested the association between rurality and risk for two mental illnesses prevalent in perinatal women - depression and anxiety.Methods: Using a cross-sectional design, antenatal and postnatal women were approached by healthcare professionals and through other networks in a county in Northern England (UK). After providing informed consent, women completed a questionnaire where they indicated their postcode (used to determine rural-urban status) and completed three outcome measures: the Edinburgh Postnatal Depression Scale (EPDS), the Whooley (depression measure), and the Generalised Anxiety Disorder 2-item (GAD-2). Logistic regression models were developed, both unadjusted and adjusted for potential confounders, including socioeconomic status, social support and perinatal stage.Results: 295 participants provided valid data. Women in rural areas (n=130) were mostly comparable to their urban counterparts (n=165). Risk for depression and/or anxiety was found to be higher in the rural group across all models: unadjusted OR 1.67 95% CI 1.03 to 2.72, p=.038. This difference though indicative did not reach statistical significance after adjusting for socioeconomic status and perinatal stage (OR 1.57 (0.40), 95% CI 0.95 to 2.58, p=.078), and for social support (OR 1.65 (0.46), 95% CI 0.96 to 2.84, p=.070).Conclusions: Data suggested that women in rural areas were at higher risk of depression and anxiety than their urban counterparts. Further work should be undertaken to corroborate these findings and investigate the underlying factors. This will help inform future interventions and the allocation of perinatal services to where they are most needed.

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Section: Introductionmentioning

confidence: 99%

Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study

Ginja

Jackson

Newham

et al. 2020

Preprint

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“…Also, in rural communities prevalence of PPD is higher worldwide. 2 So, the objective of this study was to find out the prevalence and identify the predictors of PPD in rural Udupi Taluk, Karnataka. Based on those findings appropriate recommendations can be made to deal with this burden of the problem of the community.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of postpartum depression among mothers in the rural areas of Udupi Taluk, Karnataka, India: A cross-sectional study

Agarwala

Rao

Narayanan

2019

Clinical Epidemiology and Global Health

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Postpartum depression (PPD) is a common affective disorder and is considered as an important public health problem as most of the time it remains unrecognized and affects the health of not only the mother but also the interpersonal relationships, mother-infant bonding as well as emotional and cognitive development of the baby. Objective: To estimate the prevalence and analyze the factors associated with PPD. Settings and design: A community based cross-sectional study was conducted in rural areas of Udupi Taluk, Karnataka over a period of six months. Methods and material: Four hundred ten (410) postnatal women within six months of their deliveries were interviewed using a semi-structured questionnaire, and were screened using Edinburgh Postnatal Depression Scale (EPDS). Statistical analysis: Descriptive analysis was done on socio-demographic variables, obstetric, neonatal and postnatal and psychosocial factors. Logistic regression was carried to analyze the factors associated with PPD. Results: Prevalence of PPD was 21.5%. Higher level of maternal and paternal educational status, labour complications, more than two children, history of an abortion and sleeping difficulty of the mothers were found to be statistically significant for PPD. Conclusion: Early identification of symptoms and timely referral to appropriate health care provider can prevent major depression in the postnatal period.

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“…Data on two covariate variables -socioeconomic status and social support -were collected as these could potentially explain the association between rurality and outcomes, according to previous research (3,7). Socioeconomic status was based on the index of multiple deprivation (IMD) decile, a common indicator of affluence in the UK, which was determined by searching participants' postcodes on an online tool (17).…”

Section: Covariatesmentioning

confidence: 99%

“…population(2) , (3). Other negative outcomes have been reported to be more frequent in women from rural areas, including later initiation of prenatal care, later and less use of contraceptives (4), as well as higher chances of a small-for-gestational-age birth and low birth-weight (5), all of which may add to stress levels and increase the risk of mental illness.…”

mentioning

confidence: 99%

“…Possible mediators for these rural-urban differences include difficulties in accessing healthcare services, regional variations in cultural practices, sociodemographic factors (e.g., socioeconomic status), social support and lifestyle factors(3) (5,6). Social support and socioeconomic status, in particular, have been found to be critical factors both in high and low income countries (3,7). Much of the existing literature, however, is based on exclusively rural samples, which hinders rural-urban comparisons.…”

mentioning

confidence: 99%

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Rural-Urban Differences in the Mental Health of Perinatal Women: A UK-based Cross-Sectional Study

Ginja

Jackson

Newham

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: International data suggest that living in a rural area is associated with an increased risk of perinatal mental illness. This study tested the association between rurality and two mental illnesses prevalent in perinatal women -depression and anxiety.Methods: Using a cross-sectional design, antenatal and postnatal women were approached by healthcare professionals and through other networks in North Yorkshire (England, UK). After providing informed consent, women completed a questionnaire where they indicated their postcode (used to determine rural-urban status) and completed three outcome measures: the Edinburgh Postnatal Depression Scale (EPDS), the Whooley (depression measure), and the Generalised Anxiety Disorder 2item (GAD-2). Logistic regression models were developed, both unadjusted and adjusted for potential confounders, including socioeconomic status, social support and perinatal stage.Results: 295 participants provided valid data. Women in rural areas (n=130) were mostly comparable to their urban counterparts (n=165). Higher rates of depression and/or anxiety were found in the rural group across all models: unadjusted OR 1.67 95% CI 1.03 to 2.72, p=.038. This difference though indicative did not reach statistical significance after adjusting for socioeconomic status and perinatal stage (OR 1.57 (0.40), 95% CI 0.95 to 2.58, p=.078), and for social support (OR 1.65 (0.46), 95% CI 0.96 to 2.84, p=.070).Conclusions: The evidence, though limited, suggests a higher prevalence of mental illness amongst perinatal women in rural areas. The underlying mechanisms for this increased prevalence need to be explored further in order to inform future interventions.

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An Integrative Review of Postpartum Depression in Rural U.S. Communities

Cited by 41 publications

References 45 publications

Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study

Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study

Prevalence and predictors of postpartum depression among mothers in the rural areas of Udupi Taluk, Karnataka, India: A cross-sectional study

Rural-Urban Differences in the Mental Health of Perinatal Women: A UK-based Cross-Sectional Study

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