Education level and risk of postpartum depression: results from the Japan Environment and Children’s Study (JECS)

Abstract

BackgroundLower socioeconomic status is often thought to be associated with an elevated risk of postpartum depression; however, this relationship exhibits noticeable heterogeneity between studies. The present study examined this relationship in Japan.MethodsData were obtained from 90,194 mothers in an ongoing birth cohort of the Japan Environment and Children’s Study. Socioeconomic status was assessed based on the mothers’ highest education level during pregnancy. Postpartum depression was identified at 1 and 6 months postpartum based on an Edinburgh Postnatal Depression Scale score of ≥9, and analyses were also performed based on the sub-scores for anxiety, depression, and anhedonia symptoms. Logistic and generalized linear regression model analyses were used to calculate odds ratios for postpartum depression according to education level with the highest education group (≥16 years of education) defined as the reference group, while controlling for covariates in a stepwise fashion.ResultsUnivariate analysis revealed that a lower education level was associated with a higher prevalence of postpartum depression and related symptoms. Although these relationships weakened in the fully adjusted models, odds ratios for cases and related symptoms remained significant at 1 and 6 months postpartum. Among three symptom dimensions, the relationship was strongest and weakest in the depressive and anxiety symptoms, respectively.ConclusionsA lower education level was an independent risk factor for postpartum depression. In view of the low mobility of the education level, this finding suggests the potential importance of collecting information regarding education levels at the earliest opportunity.

Effects of a psychological nursing intervention on prevention of anxiety and depression in the postpartum period: a randomized controlled trial

“…It is reported that cesarean section was associated with increased risk of postpartum depression [18]. Another study in Japan indicated that lower education level was associated with higher prevalence of postpartum depression and related symptoms [28]. Meanwhile, employment is considered as a protective factor for postpartum depression symptomatology [29].…”

Postpartum Depression: Prevalence and Associated Risk Factors Among Women in Sindh, Pakistan

“…Similarly, in a study from Japan, over 90,000 women were evaluated to find an association between education status and risk of developing PPD. The study revealed that higher education status among women was associated with a decreased rate of PPD [ 15 ]. The education level of a woman is frequently used to assess the socioeconomic status indirectly.…”

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“…What is interesting is that this work also demonstrated that in contrast with patients with higher education levels, illiterate ones did get affected by indoor daylight levels. Undoubtedly, the education levels of patients are often perceived as an adequate index for their socioeconomic status, apart from their income and occupation [21]. It has been proved that individuals with lower socioeconomic status tend to suffer from higher risks of psychiatric problems including depression, anxiety disorders and post-traumatic stress disorder [22][23][24][25].…”