title: A geographic comparison of the prevalence and risk factors for postnatal depression in an Australian population.
abstract: OBJECTIVE
  This study sought to compare the contribution of demographic and psychosocial variables on the prevalence of, and risk for, PND in urban and rural women.
  
  
  METHODS
  Demographic, psychosocial risk factor and mental health data was collected from urban (n=908) and rural (n=1,058) women attending perinatal health services in Victoria, Australia. Initial analyses determined similarities and significant differences between demographic and psychosocial variables. The association between these variables and PND case/non-case was evaluated using logistic regression analysis.
  
  
  RESULTS
  There were a number of significant differences between the two cohorts in terms of socio-economic status (SES), age, marital status and past history of psychopathology Antenatal depression was more common in the urban group compared to the rural group (8.5% vs 3.4%, p=0.006); there was no significant difference in the prevalence of PND (6.6% vs 8.5%, p=0.165). For urban mothers, antenatal EPDS score was the best predictor of PND. For rural mothers antenatal EPDS score, SES and psychiatric history had a significant influence on postnatal mood.
  
  
  CONCLUSIONS
  Findings confirm the contribution of established risk factors such as past psychopathology, antenatal EPDS score and SES on the development of PND and reiterate the need for procedures to identify and assess psychosocial risk factors for depression in the perinatal period. Other predictors such as efficacy of social support and perceived financial burden may strengthen statistical models used to predict PND for women living in a rural setting.
authors.affiliation: Department of Psychiatry, University of Melbourne, Melbourne, Australia. justin.bilszta@austin.org.au
authors.forename: Justin L C
authors.initials: JL
authors.lastname: Bilszta
authors.forename: Ying Zhi
authors.initials: YZ
authors.lastname: Gu
authors.forename: Denny
authors.initials: D
authors.lastname: Meyer
authors.forename: Anne E
authors.initials: AE
authors.lastname: Buist
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003710:Demography; D019052:Depression, Postpartum / Q000191:economics / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data; D010298:Parity; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult