title: Physical health after childbirth and maternal depression in the first 12 months post partum: results of an Australian nulliparous pregnancy cohort study.
abstract: OBJECTIVE
  to investigate the relationship between maternal physical health problems and depressive symptoms in the first year after childbirth.
  
  
  METHODS
  prospective pregnancy cohort study.
  
  
  METHODS
  Melbourne, Victoria, Australia.
  
  
  METHODS
  1507 nulliparous women.
  
  
  METHODS
  women were recruited from six public hospitals between six and 24 weeks gestation. Written questionnaires were completed at recruitment and at three, six and 12 months post partum.
  
  
  METHODS
  Edinburgh Postnatal Depression Scale (EPDS); standardised measures of urinary and faecal incontinence, a checklist of symptoms for other physical health problems.
  
  
  RESULTS
  overall, 16.1% of women reported depressive symptoms during the first 12 months post partum, with point prevalence at three, six and 12 months post partum of 6.9%, 8.8% and 7.8% respectively. The most commonly reported physical health problems in the first three months were tiredness (67%), back pain (47%), breast problems (37%), painful perineum (30%), and urinary incontinence (29%). Compared with women reporting 0-2 health problems in the first three months post partum, women reporting 5 or more health problems had a six-fold increase in likelihood of reporting concurrent depressive symptoms at three months post partum (Adjusted OR=6.69, 95% CI=3.0-15.0) and a three-fold increase in likelihood of reporting subsequent depressive symptoms at 6-12 months post partum (Adjusted OR=3.43, 95% CI 2.1-5.5).
  
  
  CONCLUSIONS
  poor physical health in the early postnatal period is associated with poorer mental health throughout the first 12 months post partum. Early intervention to promote maternal mental health should incorporate assessment and intervention to address common postnatal physical health problems.
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Melbourne 3052, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Woolhouse
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Melbourne 3052, Australia.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Gartland
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Melbourne 3052, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Perlen
authors.affiliation: Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Flemington Road, Parkville, Melbourne 3052, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Donath
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Melbourne 3052, Australia; General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne 3053, Australia. Electronic address: stephanie.brown@mcri.edu.au.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000453:epidemiology* / Q000451:nursing / Q000523:psychology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008880:Midwifery; D010298:Parity; D011181:Postnatal Care; D011247:Pregnancy; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
keywords: Back pain; Multimorbidity; Physical health; Postpartum depression