title: Poor prepregnancy and antepartum mental health predicts postpartum mental health problems among US women: a nationally representative population-based study.
abstract: OBJECTIVE
  Mental health problems disproportionately affect women, particularly during the childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy.
  
  
  METHODS
  We examined data on 1,863 mothers from 11 panels of the 1996-2006 Medical Expenditure Panel Survey. Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of "fair" or "poor."
  
  
  RESULTS
  Of the women included, 9.5% reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor prepregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between prepregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status.
  
  
  CONCLUSIONS
  Although poor antepartum mental health is the strongest predictor of postpartum mental health problems, prepregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health because they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond.
authors.affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, USA. wwitt@wisc.edu
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Wisk
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.forename: John M
authors.initials: JM
authors.lastname: Hampton
authors.forename: Paul D
authors.initials: PD
authors.lastname: Creswell
authors.forename: Erika W
authors.initials: EW
authors.lastname: Hagen
authors.forename: Hilary A
authors.initials: HA
authors.lastname: Spear
authors.forename: Torsheika
authors.initials: T
authors.lastname: Maddox
authors.forename: Thomas
authors.initials: T
authors.lastname: Deleire
mesh_terms: D000293:Adolescent; D000328:Adult; D019052:Depression, Postpartum / Q000453:epidemiology*; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology; D008603:Mental Health; D015999:Multivariate Analysis; D058725:Peripartum Period / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D014481:United States; D055815:Young Adult