Limits...
Differentials and income-related inequalities in maternal depression during the first two years after childbirth: birth cohort studies from Brazil and the UK.

Matijasevich A, Golding J, Smith GD, Santos IS, Barros AJ, Victora CG - Clin Pract Epidemiol Ment Health (2009)

Bottom Line: The Relative index of Inequality was used for the analysis of income-relate inequalities so that results were comparable between cohorts.At both the second and third time assessments, the likelihood of being depressed was higher among women from the Pelotas cohort study.These differences were not completely explained by differences in maternal and infant characteristics.

View Article: PubMed Central - HTML - PubMed

Affiliation: Post Graduate Programme in Epidemiology, Federal University of Pelotas, RS, Brazil. amatija@yahoo.com.

ABSTRACT

Background: Depression is a prevalent health problem among women during the childbearing years. To obtain a more accurate global picture of maternal postnatal depression, studies that explore maternal depression with comparable measurements are needed. The aims of the study are: (1) to compare the prevalence of maternal depression in the first and second year postpartum between a UK and Brazilian birth cohort study; (2) to explore the extent to which variations in the rates were explained by maternal and infant characteristics, and (3) to investigate income-related inequalities in maternal depression after childbirth in both settings.

Methods: Population-based birth cohort studies were carried out in Avon, UK in 1991 (ALSPAC) and in the city of Pelotas, Brazil in 2004, where 13 798 and 4109 women were analysed, respectively. Self-completion questionnaires were used in the ALSPAC study while questionnaires completed by interviewers were used in the Pelotas cohort study. Three repeated measures of maternal depression were obtained using the Edinburgh Postnatal Depression Scale in the first and second year after delivery in each cohort. Unadjusted and adjusted analyses were carried out. The Relative index of Inequality was used for the analysis of income-relate inequalities so that results were comparable between cohorts.

Results: At both the second and third time assessments, the likelihood of being depressed was higher among women from the Pelotas cohort study. These differences were not completely explained by differences in maternal and infant characteristics. Income-related inequalities in maternal depression after childbirth were high and of similar magnitude in both cohort studies at the three time assessments.

Conclusion: The burden of maternal depression after childbirth varies between and within populations. Strategies to reduce income-related inequalities in maternal depression should be targeted to low-income women in both developed and developing countries.

No MeSH data available.


Related in: MedlinePlus

Prevalence of maternal depression and 95% confidence intervals among ALSPAC and Pelotas birth cohort studies in the three time period studied. a at 8 weeks and 3 months after delivery for ALSPAC and Pelotas birth cohort, respectively. b at 8 and 12 months after delivery for ALSPAC and Pelotas birth cohort, respectively. c at 21 and 24 months after delivery for ALSPAC and Pelotas birth cohort, respectively. * x2 test for difference between the ALSPAC and the Pelotas birth cohort study in each time assessment
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2698823&req=5

Figure 1: Prevalence of maternal depression and 95% confidence intervals among ALSPAC and Pelotas birth cohort studies in the three time period studied. a at 8 weeks and 3 months after delivery for ALSPAC and Pelotas birth cohort, respectively. b at 8 and 12 months after delivery for ALSPAC and Pelotas birth cohort, respectively. c at 21 and 24 months after delivery for ALSPAC and Pelotas birth cohort, respectively. * x2 test for difference between the ALSPAC and the Pelotas birth cohort study in each time assessment

Mentions: Variations in rates of maternal depression after childbirth between the ALSPAC and Pelotas birth cohort studies and across time-periods are shown in Figure 1. The rates of maternal depression were practically the same at the first time assessment for both studies. However, at the second and third time assessments, the rates observed in the Pelotas birth cohort study were consistently higher than in the ALSPAC study. In the ALSPAC study, rates of depression were almost the same in the three time assessments (x2 trend p = 0.4), but in the Pelotas cohort study rates increased over time (x2 trend p = 0.003).


Differentials and income-related inequalities in maternal depression during the first two years after childbirth: birth cohort studies from Brazil and the UK.

Matijasevich A, Golding J, Smith GD, Santos IS, Barros AJ, Victora CG - Clin Pract Epidemiol Ment Health (2009)

Prevalence of maternal depression and 95% confidence intervals among ALSPAC and Pelotas birth cohort studies in the three time period studied. a at 8 weeks and 3 months after delivery for ALSPAC and Pelotas birth cohort, respectively. b at 8 and 12 months after delivery for ALSPAC and Pelotas birth cohort, respectively. c at 21 and 24 months after delivery for ALSPAC and Pelotas birth cohort, respectively. * x2 test for difference between the ALSPAC and the Pelotas birth cohort study in each time assessment
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698823&req=5

Figure 1: Prevalence of maternal depression and 95% confidence intervals among ALSPAC and Pelotas birth cohort studies in the three time period studied. a at 8 weeks and 3 months after delivery for ALSPAC and Pelotas birth cohort, respectively. b at 8 and 12 months after delivery for ALSPAC and Pelotas birth cohort, respectively. c at 21 and 24 months after delivery for ALSPAC and Pelotas birth cohort, respectively. * x2 test for difference between the ALSPAC and the Pelotas birth cohort study in each time assessment
Mentions: Variations in rates of maternal depression after childbirth between the ALSPAC and Pelotas birth cohort studies and across time-periods are shown in Figure 1. The rates of maternal depression were practically the same at the first time assessment for both studies. However, at the second and third time assessments, the rates observed in the Pelotas birth cohort study were consistently higher than in the ALSPAC study. In the ALSPAC study, rates of depression were almost the same in the three time assessments (x2 trend p = 0.4), but in the Pelotas cohort study rates increased over time (x2 trend p = 0.003).

Bottom Line: The Relative index of Inequality was used for the analysis of income-relate inequalities so that results were comparable between cohorts.At both the second and third time assessments, the likelihood of being depressed was higher among women from the Pelotas cohort study.These differences were not completely explained by differences in maternal and infant characteristics.

View Article: PubMed Central - HTML - PubMed

Affiliation: Post Graduate Programme in Epidemiology, Federal University of Pelotas, RS, Brazil. amatija@yahoo.com.

ABSTRACT

Background: Depression is a prevalent health problem among women during the childbearing years. To obtain a more accurate global picture of maternal postnatal depression, studies that explore maternal depression with comparable measurements are needed. The aims of the study are: (1) to compare the prevalence of maternal depression in the first and second year postpartum between a UK and Brazilian birth cohort study; (2) to explore the extent to which variations in the rates were explained by maternal and infant characteristics, and (3) to investigate income-related inequalities in maternal depression after childbirth in both settings.

Methods: Population-based birth cohort studies were carried out in Avon, UK in 1991 (ALSPAC) and in the city of Pelotas, Brazil in 2004, where 13 798 and 4109 women were analysed, respectively. Self-completion questionnaires were used in the ALSPAC study while questionnaires completed by interviewers were used in the Pelotas cohort study. Three repeated measures of maternal depression were obtained using the Edinburgh Postnatal Depression Scale in the first and second year after delivery in each cohort. Unadjusted and adjusted analyses were carried out. The Relative index of Inequality was used for the analysis of income-relate inequalities so that results were comparable between cohorts.

Results: At both the second and third time assessments, the likelihood of being depressed was higher among women from the Pelotas cohort study. These differences were not completely explained by differences in maternal and infant characteristics. Income-related inequalities in maternal depression after childbirth were high and of similar magnitude in both cohort studies at the three time assessments.

Conclusion: The burden of maternal depression after childbirth varies between and within populations. Strategies to reduce income-related inequalities in maternal depression should be targeted to low-income women in both developed and developing countries.

No MeSH data available.


Related in: MedlinePlus