Postpartum depression and timing of spousal military deployment relative to pregnancy and delivery.
OBJECTIVE
This study aimed to determine the relationship between spousal deployment and postpartum depression diagnosis among U.S. military wives, accounting for the timing of deployment with respect to pregnancy and delivery.


METHODS
A retrospective cohort study was conducted to evaluate the association between spousal deployment and postpartum depression among pregnant wives of active-duty service members. Electronic medical records for 161,454 births occurring between 2004 and 2009 were used to define postpartum depression. Three non-mutually exclusive exposure variables were created to categorize deployments as occurring before, during, or after the infant's delivery. A multivariable logistic regression model mutually adjusted for these exposure variables was fitted, producing an odds ratio for each of the three timing categories.


RESULTS
A modest significant association was detected only in those whose husbands deployed in pregnancy and returned after delivery (i.e., deployed during delivery) [odds ratio (OR) 1.10, 95 % confidence interval (CI) 1.04-1.15]. An interactive effect between preexisting depression or anxiety and deployment during delivery was also detected in the data (OR 1.13, 95 % CI 1.07-1.20 for those without a preexisting diagnosis; OR 0.87, 95 % CI 0.80-0.95 for those with a preexisting diagnosis).


CONCLUSIONS
Health care providers should continue to be aware of spousal deployment as a military-unique stressor in this population and rigorously screen for potential symptoms of postpartum depression, especially among those whose husbands are absent at delivery.
Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA, jordan.levine@med.navy.mil.
Jordan A
JA
Levine
Anna T
AT
Bukowinski
Carter J
CJ
Sevick
Krista M
KM
Mehlhaff
Ava Marie S
AM
Conlin
D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000523:psychology*; D019052:Depression, Postpartum / Q000453:epidemiology / Q000209:etiology*; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008889:Military Personnel; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D018454:Spouses / Q000523:psychology*