Research reportEmployment, income, and education and risk of postpartum depression: The Osaka Maternal and Child Health Study
Introduction
Depression in the postpartum period is a serious mental health disorder that confers great disability on women and has been associated with negative effects on the marital relationship and cognitive, social, and emotional development of offspring (O'Hara, 2009). In a meta-analysis in 2001, the following 13 predictors of postpartum depression were revealed: prenatal depression, self esteem, childcare stress, prenatal anxiety, life stress, social support, marital relationship, history of previous depression, infant temperament, maternity blues, marital status, socioeconomic status, and unplanned/unwanted pregnancy; however, the relationship with socioeconomic status was in the range of a small effect size (Beck, 2001). In fact, epidemiological evidence regarding the associations of employment, income, and education with the risk of postpartum depression is inconsistent. In Japan, such evidence is nonexistent. To our knowledge, no epidemiological study has examined the relationship between type of job and the risk of postpartum depression. Here, we investigated the association between employment, type of job, household income, and educational level and the risk of postpartum depression using data from the Osaka Maternal and Child Health Study (OMCHS).
Section snippets
Study population
The OMCHS is a prospective cohort study that investigates preventive and risk factors for maternal and child health problems such as partum depression and allergic disorders. Pregnant women were recruited for the baseline survey of the OMCHS. Eligible pregnant women were those who lived in Neyagawa City, which is one of the 43 municipalities in Osaka Prefecture, a metropolis in Japan with a total population of approximately 8.8 million. In Japan, when women become pregnant, they notify the
Results
The prevalence of postpartum depression was 13.8% among the 771 women who participated in the second survey at 3–4 months postpartum. The mean age of the 771 women was 29.9 years at baseline (Table 1).
Table 2 provides ORs and the 95% CIs for the risk of postpartum depression associated with selected socioeconomic variables. Compared with unemployment, employment was significantly related to a reduced risk of postpartum depression. Adjustment for age, gestation, parity, cigarette smoking, family
Comparison with other studies
The current study showed that compared with unemployment, employment, especially full-time employment and holding a professional or technical job, was significantly associated with a reduced risk of postpartum depression. There were no relationships between household income or maternal and paternal educational levels and the risk of postpartum depression.
In a cross-sectional study in the United States, significantly higher percentages of moderate-severe depression symptoms were found among
Conflict of Interest
All authors declare that they have no conflicts of interest.
Role of the funding source
Funding for this study was provided by KAKENHI (13770206, 16790351, and 22119507) and Health and Labour Sciences Research Grants, Research on Allergic Disease and Immunology from the Ministry of Health, Labour, and Welfare, Japan.
Contributors
Author Yoshihiro Miyake contributed to the study design, data collection, statistical analysis, data interpreting, and manuscript writing. Author Keiko Tanaka contributed to the data collection and data management. Author Satoshi Sasaki contributed to the study design. Author Yoshio Hirota contributed to the supervision of the design and execution of the study.
Acknowledgements
The authors would like to acknowledge the Neyagawa City Government, Hirakata City Government, Katano City Government, Shijonawate City Government, Kaizuka City Government, Takaishi City Government, Hannan City Government, Neyagawa City Medical Association, Hirakata City Medical Association, and the Kadoma City Medical Association for their valuable support.
References (28)
- et al.
Postpartum-onset major depression is associated with personality disorders
Compr. Psychiatry
(2007) - et al.
How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers?
Womens Health Issues
(2010) - et al.
Prevalence and risk factors for a high level of postnatal depression symptomatology in Italian women: a sample drawn from ante-natal classes
Eur. Psychiatry
(2009) - et al.
Predictive validation study of the Edinburgh Postnatal Depression Scale in the first week after delivery and risk analysis for postnatal depression
J. Affect. Disord.
(2006) - et al.
Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms
Obstet. Gynecol.
(2002) - et al.
Depression symptom prevalence and demographic risk factors among U.S. women during the first 2 years postpartum
J. Obstet. Gynecol. Neonatal Nurs.
(2007) - et al.
A comparative study of postnatal depression and its predictors in Taiwan and mainland China
Am. J. Obstet. Gynecol.
(2003) Predictors of postpartum depression: an update
Nurs. Res.
(2001)- et al.
Prevalence, stability, and socio-demographic correlates of depressive symptoms in Black mothers during the first 18 months postpartum
Matern. Child Health J.
(2003) - et al.
Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale
Br. J. Psychiatry
(1987)