Unintended pregnancy and postpartum depression among first-time mothers

Background: Postpartum depression is a mental disorder that occurs after birth and has negative consequences for the mother, infant, and family. The objective of this secondary analysis was to examine whether pregnancy intention was associated with postpartum depression among first-time mothers. Methods: The First Baby Study is a prospective cohort study of women aged 18-35 having a first singleton birth in Pennsylvania. Baseline data were collected during the third trimester. Postpartum depressive symptoms were measured at 1-month postpartum using the Edinburgh Postnatal Depression Scale. Logistic regression was performed to examine the association between unintended pregnancy and postpartum depression, controlling for prepregnancy anxiety/depression and sociodemographic data. Results: Of 2972 first-time mothers, 83.4% were white, 70.7% were married, and 56.9% were college educated. Nine hundred fifty-two women (32.0%) reported their pregnancy was unintended and 151 (5.1%) met the threshold for postpartum depression. The prevalence of postpartum depression was higher in women with unintended pregnancies compared to women with intended pregnancies (6.7% vs. 4.3%, p<0.01). However, after controlling for confounders, unintended pregnancy was no longer associated with postpartum depression (adjusted OR 1.41; 95% CI 0.91-2.18). Variables independently associated with postpartum depression included prepregnancy anxiety/depression, Asian race, and Hispanic ethnicity. Conclusion: Pregnancy intention was not independently associated with postpartum depression among first time mothers in Pennsylvania.