Maternal Correlates of Postpartum Depressive Symptoms Among a Sample of Urban, Predominantly African American Mothers.

Objectives: This study examined associations between maternal characteristics, mental health services use, and trajectories of postpartum depressive (PPD) symptoms. Methods: Secondary analysis of longitudinal data of mothers <8 months postpartum with PPD symptoms, collected as part of a larger randomized controlled trial. Mothers completed measures of demographic characteristics, parenting, and social support at baseline and monthly reports of Mental Health Services Use and Edinburgh Postnatal Depression Scale (EPDS) scores. Univariate and multivariable mixed-effects linear regression models assessed associations between maternal characteristics, psychosocial variables, and mental health services with changes in EPDS scores. Results: Most mothers were Black (72.5%), single (68.1%), and with a high school education or less (50.6%). Average EPDS scores were moderate at baseline, declined over 9 months, but were still high by study end. Univariate analysis showed parenting competence (β = -0.073, 95% confidence interval [95% CI] [-0.14, 0.00]) and perceived social support (β = -0.051, 95% CI [-0.09, 0.00]) were negatively associated with overall EPDS, while parenting stress was positively associated (β = 0.063, 95% CI [0.03, 0.10]). Psychosocial variables were not significantly associated with EPDS in the multivariate model. EPDS scores were higher at baseline among those who reported mental health treatment than those who did not, but score declines were similar in both groups. Conclusions: EPDS scores declined but remained elevated over the postpartum period among the cohort. Those who reported mental health treatment had higher but similar declines than those who did not. These findings support policy initiatives to provide 12 months of postpartum coverage for new mothers.