WASHINGTON – A two-part behavioral, educational intervention reduced rates of postpartum depression in black and Hispanic women by approximately one-third for up to 6 months, based on data from a randomized trial of 540 new mothers.
"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell of Mount Sinai Medical Center in New York said.
Previous studies have suggested that factors such as poor social support, overload from the demands of daily life, and physical symptoms contribute to postpartum depression, she said at the annual meeting of the Society for Prevention Research.
In this study, Dr. Howell and her colleagues developed a behavioral, educational intervention to reduce postpartum depression in a high-risk population of minority women. The intervention included a 15-minute review of a patient-education booklet and partner summary sheet with a trained bilingual social worker before the women left the hospital. The second part of the intervention was a phone call from the social worker at 2 weeks post partum to assess the women’s symptoms, symptom management skills, and other issues. When needed, the social worker helped the 270 women in this group develop action plans to manage symptoms and access community resources. The findings also were published in the May issue of Obstetrics & Gynecology (2012;119:942-9).
"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell said.
The educational pamphlet presented possible triggers of postpartum depression as normal elements of the postpartum experience, such as hair loss, bleeding, back pain, incision pain or episiotomy site pain, infant colic, and feeling sad or blue.
The 270 in the control group received a list of community resources instead of the detailed pamphlet, and a 2-week control phone call.
The study participants were evaluated for depression (defined as a score of 10 or greater on the Edinburgh Postnatal Depression Scale) before randomization and at 3 weeks, 3 months, and 6 months.
Overall, positive depression scores were significantly less common in the intervention group, compared with the controls, at 3 weeks (9% and 15%, respectively). Depression scores remained less common in the intervention group, compared with controls, at 3 months (8% vs. 13%) and 6 months (9% vs. 14%), although these differences did not reach statistical significance.
In an intent to treat analysis, mothers in the intervention group had a 33% reduced risk of screening positive for depression for up to 6 months post partum.
The mean age of the women was 28 years, 62% were Hispanic, and 41% were having their first child.
The study was limited by the relatively low rate of positive depressive symptoms, compared with data from other studies of high-risk minority women, the researchers noted. However, the results suggest that factors reported to contribute to postpartum depression can be addressed and modified.
"It is important to note that the effect during the first 6 months post partum would likely benefit the infant, mother, and family," they added.
Dr. Howell had no financial conflicts to disclose. The study was funded by the National Institutes of Health.