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BACKGROUND: The negative maternal and childhood effects of postpartum depression are well documented. Previous research has not investigated the relationship between women’s reactions to perceived racism and subsequent postpartum depression in a population-based setting.
METHODS: Michigan PRAMS data (2009-2010) were used to measure binary exposure (reported feelings of anger/sadness/frustration resulting from race-based treatment during 12 months before delivery) and outcome (score ≥8 on PRAMS postpartum depression scale) variables. Potential confounders considered were maternal age, education, pre-pregnancy insurance status, pregnancy intention, and a proxy for marital status. Logistic regression models were constructed separately for non-Hispanic (NH) black and white women. Parsimonious models were fit by backward selection, using the 10% rule.
RESULTS: NH Black mothers experienced a significantly higher prevalence of postpartum depression than their NH white counterparts (18.9%, 95% CI: 16.6-21.4] and 12.1%, [95% CI: 10.4-13.9], respectively). Exposed black women were three times more likely to suffer postpartum depression than non-exposed black mothers: this relationship was not confounded by measured variables (prevalence ratio [PR]: 2.98, [95% CI: 2.19-4.06]). Exposed white mothers were two and a half times more likely to experience postpartum depression than unexposed white mothers (crude PR: 2.52, 95% CI: [1.71-3.70]); however, this association was partly explained by pregnancy intention and marital status (adjusted PR: 1.98, 95% CI: 1.28-3.07).
CONCLUSIONS: Although these results do not imply causality, information about prenatal reactions to racism may be useful for identifying women at high risk for developing postpartum depression.