title: The Relationship Between Postpartum Depression and Perinatal Cigarette Smoking: An Analysis of PRAMS Data.
abstract: BACKGROUND
  This study examines the relationship between postpartum depression (PPD) and cigarette smoking from prior to pregnancy to postpartum.
  
  
  METHODS
  The study sample consisted of 29,654 U.S. women who reported smoking in the 3months prior to pregnancy and for whom data on PPD were available from the Pregnancy Risk Assessment Monitoring System (PRAMS). Two sets of analyses were conducted. The first compared smoking at 2 time points (prior to pregnancy and postpartum) and the second at 3 time points (prior to pregnancy, during pregnancy, and postpartum). PPD was defined as responses of "often" or "always" to 2 questions: "Since your baby was born, how often have you felt down, depressed, or sad?" and "Since your new baby was born, how often have you had little interest or little pleasure in doing things?"
  
  
  RESULTS
  Overall, 22% of the sample endorsed PPD symptoms. In the 2 time-point analysis, controlling for known confounders, participants whose smoking was reduced or unchanged postpartum were about 30% more likely to have PPD compared to those who quit (OR: 1.34; 95% CI=1.10-1.60, p=0.001; OR:1.32; 95% CI: 1.10-1.50, p<0.001 respectively). Participants who increased smoking postpartum were 80% more likely to have PPD compared those who quit (OR: 1.80; 95% CI: 1.50-2.30, p<0.001). In the 3 time-point analysis, participants who continued smoking at any level during pregnancy and postpartum had 1.48 times the odds of reporting PPD (95% CI: 1.26, 1.73) compared to those who quit during pregnancy and remained quit postpartum. Participants who quit during pregnancy but resumed postpartum had 1.28 times the odds of reporting PPD (95% CI: 1.06, 1.53) compared to those who quit during pregnancy and remained quit postpartum.
  
  
  CONCLUSIONS
  Results suggest an association among women who smoke cigarettes prior to pregnancy between PPD and continued smoking during pregnancy and postpartum.
authors.affiliation: University of Maryland, Baltimore, Department of Epidemiology and Public Health.
authors.forename: Shabnam
authors.initials: S
authors.lastname: Salimi
authors.affiliation: University of Maryland School of Medicine, Department of Epidemiology and Public Health; Behavioral Health System Baltimore.
authors.forename: Mishka
authors.initials: M
authors.lastname: Terplan
authors.affiliation: Maryland Department of Health and Mental Hygiene, Maternal and Child Health Bureau.
authors.forename: Diana
authors.initials: D
authors.lastname: Cheng
authors.affiliation: Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences. Electronic address: Mchisol1@jhmi.edu.
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Chisolm
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D011247:Pregnancy; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Postpartum depression; Pregnancy; Smoking
references.citation: J Affect Disord. 2011 Apr;130(1-2):133-7
references.pmid: 21055825
references.citation: Womens Health Issues. 2010 Mar-Apr;20(2):96-104
references.pmid: 20133153
references.citation: Drug Alcohol Depend. 2007 Oct 8;90(2-3):224-7
references.pmid: 17475418
references.citation: MMWR Surveill Summ. 2009 May 29;58(4):1-29
references.pmid: 19478726
references.citation: Violence Against Women. 2013 Apr;19(4):503-17
references.pmid: 23660619
references.citation: J Consult Clin Psychol. 2010 Feb;78(1):44-54
references.pmid: 20099949
references.citation: J Am Board Fam Pract. 2004 Jul-Aug;17(4):264-75
references.pmid: 15243014
references.citation: J Consult Clin Psychol. 2012 Aug;80(4):636-48
references.pmid: 22390410
references.citation: Am J Public Health. 2002 Nov;92(11):1801-8
references.pmid: 12406812
references.citation: J Gen Intern Med. 1997 Jul;12(7):439-45
references.pmid: 9229283
references.citation: J Epidemiol Community Health. 2006 Mar;60(3):221-7
references.pmid: 16476752
references.citation: Matern Child Health J. 2012 May;16(4):887-93
references.pmid: 21559774
references.citation: Natl Vital Stat Rep. 2007 Dec 5;56(6):1-103
references.pmid: 18277471
references.citation: MMWR Morb Mortal Wkly Rep. 2008 Aug 8;57(31):849-52
references.pmid: 18685552
references.citation: Qual Health Res. 2002 Apr;12(4):453-72
references.pmid: 11939248
references.citation: J Perinat Educ. 2002 Fall;11(4):25-36
references.pmid: 17273318
references.citation: Am J Nurs. 2006 May;106(5):40-50; quiz 50-1
references.pmid: 16639243
references.citation: Women Health. 2004;39(3):19-34
references.pmid: 15256353
references.citation: Am J Prev Med. 2009 Jan;36(1):9-12
references.pmid: 19095161
references.citation: Am J Prev Med. 2003 Jan;24(1):29-35
references.pmid: 12554021
references.citation: Public Health Rep. 2006 Jan-Feb;121(1):74-83
references.pmid: 16416701
references.citation: Matern Child Health J. 2010 Mar;14(2):261-7
references.pmid: 19669394
references.citation: Lancet. 2004 Jan 24;363(9405):303-10
references.pmid: 14751705
references.citation: Matern Child Health J. 2007 May;11(3):257-67
references.pmid: 17171544
references.citation: Can J Clin Pharmacol. 2009 Winter;16(1):e15-22
references.pmid: 19164843
references.citation: J Reprod Med. 2008 Mar;53(3):166-70
references.pmid: 18441719
references.citation: Public Health Rep. 2011 Jan-Feb;126(1):50-9
references.pmid: 21337931
references.citation: Prog Neuropsychopharmacol Biol Psychiatry. 2013 Jan 10;40:199-206
references.pmid: 23063492
references.citation: J Perinat Educ. 2009 Spring;18(2):23-31
references.pmid: 20190853
references.citation: J Womens Health (Larchmt). 2014 Feb;23(2):120-8
references.pmid: 24160774
references.citation: Am J Prev Med. 2000 Oct;19(3):193-6
references.pmid: 11020597
references.citation: Nicotine Tob Res. 2009 Jun;11(6):707-14
references.pmid: 19436040
references.citation: Arch Womens Ment Health. 2012 Feb;15(1):31-7
references.pmid: 22215286
references.citation: Arch Womens Ment Health. 2013 Aug;16(4):259-70
references.pmid: 23740222
references.citation: Nicotine Tob Res. 2008 Nov;10(11):1609-20
references.pmid: 18988073