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

Alicia Matijasevich, Jean Golding, George Davey Smith, Iná S. Santos, Aluísio J D Barros, Cesar G. Victora

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article number12
JournalClinical Practice and Epidemiology in Mental Health
Volume5
DOIs
StatePublished - Jun 5 2009
Externally publishedYes

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Brazil
Cohort Studies
Mothers
Parturition
Depression
Postpartum Depression
Developed Countries
Postpartum Period
Population
Developing Countries
Interviews
Health

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Epidemiology

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Differentials and income-related inequalities in maternal depression during the first two years after childbirth : Birth cohort studies from Brazil and the UK. / Matijasevich, Alicia; Golding, Jean; Smith, George Davey; Santos, Iná S.; Barros, Aluísio J D; Victora, Cesar G.

In: Clinical Practice and Epidemiology in Mental Health, Vol. 5, 12, 05.06.2009.

Research output: Contribution to journalArticle

Matijasevich, Alicia ; Golding, Jean ; Smith, George Davey ; Santos, Iná S. ; Barros, Aluísio J D ; Victora, Cesar G. / Differentials and income-related inequalities in maternal depression during the first two years after childbirth : Birth cohort studies from Brazil and the UK. In: Clinical Practice and Epidemiology in Mental Health. 2009 ; Vol. 5.
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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.",
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