Postpartum Perceived Stress Predicts Depressive Symptoms for Two Years after Birth, Study Finds

Women with higher levels of postpartum perceived stress were more likely to report depressive symptoms six months later, and that relationship persisted for 24 months after giving birth. These are among the findings of a study selected as the Editor’s Choice for the July/August issue of Women’s Health Issues

Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.

Krista S. Leonard, a doctoral student in the Department of Kinesiology, and Drs. Blair Evans, Kristen Kjerulff, and Danielle Symons Downs, Penn State, examined the relationship between perceived stress, perceived social support, and depressive symptoms at six-month intervals after childbirth in more than 1,000 Pennsylvania women who participated in the First Baby Study. Over the course of 24 months, the researchers found that perceived social support declined while perceived stress increased; depressive symptoms essentially remained constant but then increased from 18 to 24 months postpartum.

The authors used mediation models to examine the relationship between postpartum perceived stress, perceived social support, and depressive symptoms. They found that “the association between perceived social support and depressive symptoms at all time points was mediated by perceived stress such that lower levels of perceived social support predicted perceived stress,” and in turn, predicted depressive symptoms.

The findings demonstrate the need to continue screening for depression long after the six-week postpartum visit, when health care providers typically ask women about postpartum depressive symptoms. Leonard and colleagues suggest that interventions to strengthen support systems in the months after childbirth could help women manage perceived stress, and in turn reduce depressive symptoms well beyond the early postpartum. 

“[A]lthough there is often a lot of support after the birth of the baby, this attention quickly declines within the first few postpartum weeks; many women feel that others do not understand this support is still needed in the continued months after childbirth as women adjust to their role as a mother along with sleepless nights, hormonal changes, and returning to work,” the authors write.   

“Postpartum depression is a major public health problem, and we must improve our understanding of the factors involved in order to address it effectively,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and Associate Professor of prevention and community health at Milken Institute SPH. “This study makes an important contribution by identifying potential pathways for interventions.”

Postpartum Perceived Stress Explains the Association between Perceived Social Support and Depressive Symptoms” has been published in the July/August issue of Women’s Health Issues.