title: The relationship between parental stress and postpartum depression among adolescent mothers enrolled in a randomized controlled prevention trial.
abstract: Given the high co-occurrence of depression and parental stress among adolescent mothers, we evaluated the relationship between parental stress and postpartum depression among primiparous adolescent mothers. We conducted an observational analysis among a cohort of 106 adolescent mothers at 289 postpartum visits who were enrolled in a randomized controlled trial to prevent postpartum depression. Parental stress was measured using the Parenting Stress Index, short form. The Structured Clinical Interview for DSM-IV Childhood Diagnoses was administered to assess for postpartum depression; subthreshold depression was assessed using the Children's Depression Rating Scale, revised version. Generalized estimating equations were utilized to assess the relationship of parental stress on postpartum depression during the first 6 months postpartum. We present adjusted odds ratios (AOR) controlling for study arm, age, born in the United States, prior history of depression, and number of study visits. The median age was 16 years, 53% were Latina, and 16% reported a past history of depression. Nineteen adolescents (19%) were diagnosed with postpartum depression and 25% experienced high levels of parental stress through 6 months postpartum. Adolescent mothers who reported higher levels of parental stress were at significantly increased risk for postpartum depression [AOR 1.06 (95% CI 1.04-1.09); p < 0.0001]. High levels of parental stress predicted subsequent postpartum depression when assessing parental stress at visits prior to a depression diagnosis to determine whether we could establish a temporal association [AOR 1.06 (95% CI 1.02-1.09); p < 0.01]. Parental stress was also a risk factor for subthreshold depression [AOR 1.04 (95% CI 1.01-1.07); p < 0.01]. Parental stress was a significant risk factor for developing both postpartum depression as well as subthreshold depression among adolescent mothers. Interventions that target a reduction in parental stress may lead to less depression severity among primiparous adolescent mothers.
authors.affiliation: Department of Obstetrics and Gynecology, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, kvenkatesh@partners.org.
authors.forename: Kartik K
authors.initials: KK
authors.lastname: Venkatesh
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Phipps
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Triche
authors.forename: Caron
authors.initials: C
authors.lastname: Zlotnick
mesh_terms: D000293:Adolescent; D019052:Depression, Postpartum / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D010298:Parity; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications*